From the Guidelines
There is currently no strong evidence to support the use of marijuana as a primary treatment for psoriatic arthritis, and conventional treatments such as DMARDs, biologics, and NSAIDs are recommended as the first line of treatment. While some patients report that cannabis helps reduce pain and inflammation associated with psoriatic arthritis, high-quality clinical studies focused on this particular condition are lacking 1. The cannabinoids in marijuana, particularly CBD and THC, have demonstrated anti-inflammatory and pain-relieving properties in general arthritis research, which might theoretically benefit psoriatic arthritis symptoms 1.
Key Considerations
- Conventional treatments like DMARDs, biologics, and NSAIDs have stronger evidence supporting their effectiveness for psoriatic arthritis 1.
- Marijuana may interact with other medications, particularly immunosuppressants commonly used for psoriatic arthritis 1.
- Side effects of marijuana can include dizziness, dry mouth, impaired cognition, and potential lung issues if smoked 1.
Administration and Dosage
For those considering marijuana as a potential adjunctive treatment, starting with CBD-dominant products with low THC content might minimize psychoactive effects while potentially providing symptom relief. Common administration methods include:
- Oils taken sublingually (5-20mg CBD twice daily)
- Topical applications directly on affected joints
- Vaporized cannabis for faster relief
Recommendation
Patients should discuss the option of using marijuana with their rheumatologist before trying it, as the current evidence does not support its use as a primary treatment for psoriatic arthritis. A thorough evaluation of the potential benefits and risks, as well as consideration of conventional treatment options, is necessary to make an informed decision 1.
From the Research
Evidence for Marijuana Use in Psoriatic Arthritis
- There is limited research directly linking marijuana use to the treatment of psoriatic arthritis, but some studies suggest that cannabis may have potential benefits for patients with the condition 2.
- A 2022 study found that 30% of psoriatic disease patients reported using cannabis in the last year, with primary perceived benefits being aid in sleep and arthritis pain relief 2.
- However, the same study found no difference in pain scores between cannabis users and non-users, suggesting that the relationship between cannabis use and pain relief in psoriatic arthritis may be complex 2.
- The study also found that serum IL-23 levels were statistically significantly higher in non-users than in users, which could have implications for the treatment of psoriatic arthritis 2.
Traditional Treatments for Psoriatic Arthritis
- Traditional disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine, leflunomide, and cyclosporine have been shown to have moderate symptom-modifying effects on psoriatic synovitis 3.
- Biologic therapies, including anti-tumor necrosis factor (TNF) agents, have been found to be effective in treating the signs and symptoms of psoriatic arthritis, as well as reducing radiographic progression 4, 5.
- Methotrexate has been found to be slightly more effective than placebo in improving disease response, function, and disease activity in patients with psoriatic arthritis, although the evidence is of low quality 6.
Gaps in Research
- There is a need for further studies on the use of cannabis in psoriatic arthritis, including its effects on pain, health-related quality of life, and cytokine levels 2.
- More research is also needed on the long-term effects of traditional DMARDs and biologic therapies in patients with psoriatic arthritis 3.