←Chronic Pain
Study register · detail Chronic Pain · 2018

Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management – An overview of systematic reviews

Häuser et al. ·European Journal of Pain Impact 2.6
Mixed 165 citations
Sample—
DurationSystematic review of studies…
ControlPlacebo
EndpointPain intensity
Blindingunklar
Key finding

Inconsistent findings on the efficacy of cannabis-based medicines for neuropathic pain and muscle spasms in MS; insufficient evidence for rheumatic diseases and cancer pain.

Summary

Umbrella review of k=10 systematic reviews (2009–2017) on cannabis-based medicines in chronic pain; 4 SRs of high and 6 of moderate methodological quality (AMSTAR). Inconsistent findings on efficacy for neuropathic pain (4 SRs) and painful MS spasms (1 SR); insufficient evidence for rheumatic pain (3 SRs) and tumor pain (2 SRs). Inconsistent results regarding tolerability and safety.

P
PopulationAdults with chronic pain (neuropathic pain, MS spasticity, rheumatic diseases, tumor pain) — pooled from 10 systematic reviews
I
InterventionCannabis-based medicines (various cannabinoids, various forms of administration)
C
ControlPlacebo (within the included RCT-SRs)
O
OutcomeInconsistent evidence for neuropathic pain and MS spasticity; insufficient evidence for rheumatic diseases and tumor pain
Quality profile
Sample size —
Blinding —
Effect size Mixed
Citations / year ★★★★★
Authors
Häuser W, Petzke F, Fitzcharles M
DOI 10.1002/ejp.1118↗
Share
Abstract
Significance: We provide an overview of systematic reviews on the efficacy, tolerability and safety of cannabis-based medicines for chronic pain management. There are inconsistent findings of the efficacy of cannabinoids in neuropathic pain and painful spasms in multiple sclerosis. There are inconsistent results on tolerability and safety of cannabis-based medicines for any chronic pain.
Indication
Further studies on Chronic Pain
All studies →
S Hjorthøj et al. · 2022 · European Journal of Pain
12 citations
Cannabis-based medicines and medical cannabis for patients with neuropathic pain and other pain disorders: Nationwide register-based pharmacoepidemiologic comparison with propensity score matched controls
Mixed Cochrane Review

Cochrane SR über cannabisbasierte Medikamente bei neuropathischen und anderen Schmerzen; inkludiert Fibromyalgie-Subgruppenanalyse: 5 RCTs (n=445), niedrige Evidenzqualität, keine signifikante Schmerzreduktion vs. Placebo (SMD -0.21, 95% CI -0.61 bis 0.19).

10.1002/ejp.1874 View study →
S Karst et al. · 2025 · Nature Medicine
13 citations
Full-spectrum extract from Cannabis sativa DKJ127 for chronic low back pain: a phase 3 randomized placebo-controlled trial
Clear benefit RCT (Phase III, multizentrisch, placebo-kontrolliert)

Phase-III-RCT, n=820 Erwachsene mit chronischem Rückenschmerz (CLBP); VER-01 (Cannabis-Vollspektrum-Extrakt) vs. Placebo über 12 Wochen. Primärer Endpunkt erreicht: mittlere NRS-Schmerzreduktion -1,9 Punkte (MD vs. Placebo -0,6; 95%-KI -0,9 bis -0,3; p<0,001). Schlüsselsekundärendpunkt (neuropathische Schmerzkomponente): NPSI -14,4 Punkte (MD vs. Placebo -7,3; 95%-KI -13,2 bis -1,3; p=0,017). Effekte in 6-monatiger Open-Label-Extension aufrechterhalten (NRS -2,9); kein Abhängigkeitssignal.

10.1038/s41591-025-03977-0 View study →
S Whiting et al. · 2015 · JAMA
2103 citations
Cannabinoids for Medical Use
Mixed

Umfassende SR über 79 RCTs (n=6.462) zu medizinischem Cannabis; moderate Evidenz für chronischen Schmerz (6 RCTs), neuropathischen Schmerz, MS-Spastik; NNTB=6 für 30% Schmerzreduktion; häufigste NW: Schwindel, trockener Mund, Sedierung.

10.1001/jama.2015.6358 View study →

The impediment to action advances action. — Marcus Aurelius