Effect of benzopyranoperidine, a delta-9-THC congener, on pain.

Jochimsen et al. ·Clinical Pharmacology & Therapeutics

No benefit demonstrated GRADE Moderate 51 citations

Samplen = 35 Pat.

DurationSingle dose

ControlPlacebo and codeine 60 mg / 120 mg oral

EndpointPain relief score

Blindingdoppelblind

DesignRCT (cross-over, 5-fach)

Cannabinoidthc

Max. dose4.0 mg

Routeoral

Key finding

Benzopyranoperidine showed no analgesic effect versus placebo and was inferior to codeine; both doses tended to increase pain perception.

Summary

n=35 cancer pain patients, benzopyranoperidine (THC analogue) 2 mg / 4 mg vs. codeine 60 mg / 120 mg vs. placebo (5-way crossover); no significant difference between placebo and benzopyranoperidine; codeine 120 mg showed clinically relevant pain reduction. THC analogue not more effective than placebo; pain perception tended to be increased under both doses.

PopulationAdults with chronic tumor pain, n=35

InterventionBenzopyranoperidine (BPP, delta-9-THC analogue) 2 mg and 4 mg oral, single dose

ControlPlacebo and codeine 60 mg / 120 mg oral

OutcomeNo consistent difference between placebo and BPP; codeine 120 mg showed clinically relevant pain relief; BPP not more effective than placebo, possibly pain-enhancing

Confidence in the evidence

Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for

Imprecision

Quality profile

Sample size ★★★★★

Blinding Double-blind

Effect size No benefit

Citations / year ★★★★★

Authors

Jochimsen PR, Lawton RL, VerSteeg K, Noyes R.

DOI 10.1002/cpt1978242223↗

Design: RCT (cross-over, 5-fach)

Abstract

In a double-blind, 5-way crossover designed study, single doses of placebo, 2 doses of codeine sulfate (60 and 120 mg), and 2 doses of benzopyranoperidine (2 and 4 mg) were administered orally to 35 patients who required analgesics for chronic pain due to malignancies. Benzopyranopyridine is an analogue of delta-9-tetrahydrocannabinol and was chosen on the basis of its sedative, hypnotic, and analgesic properties in animals. Pain relief scores indicated a degree of relief of clinical significance with 120 mg of codeine but no consistent difference between placebo and any other active agent. On the basis of the data, bezopyranoperidine (2 or 4 mg) is not as effective as codeine (120 mg or 60 mg) and not more effective than placebo in relieving pain due to cancer; indeed, pain perception appeared to be augmented by both doses.

The impediment to action advances action. — Marcus Aurelius