Evidence supporting the benefits of Cannabis for Crohn’s disease and ulcerative colitis is extremely limited: a meta-analysis of the literatureEvidence supporting the benefits of Cannabis for Crohn’s disease and ulcerative colitis is extremely limited: a meta-analysis of the literature

<h4>Background</h4>Medical Cannabis is increasingly used to control inflammation and pain in inflammatory bowel disease (IBD). We performed a meta-analysis to investigate the effect of Cannabis on the clinical response, induction of clinical remission, and maintenance of clinical remission compared to placebo/standard of care.<h4>Methods</h4>We performed a systematic search of PubMed, Embase, and Web of Science in June 2019, for cannabis/Cannabis and IBD, Crohn's disease or ulcerative colitis (UC). The statistical analysis was performed using Revman (version 5.3). GRADE methodology was used to assess the quality of the evidence.<h4>Results</h4>Of the 334 studies initially reviewed, 1 trial in UC and 2 trials in Crohn's disease met eligibility. For UC, 29 patients were treated with Cannabis and 31 with placebo/standard of care. There was no difference in failure to achieve clinical remission (relative risk [RR] 1.02, 95% confidence interval [CI] 0.76-1.37) or response (RR 0.99, 95%CI 0.65-1.21). Adverse events occurred in all patients receiving Cannabis (RR 1.28, 95%CI 1.05-1.56). For Crohn's disease, 21 patients were treated with Cannabis and 19 with placebo/standard of care. There was no difference in failure to achieve clinical remission (RR 0.72, 95%CI 0.47-1.12) or failure to achieve clinical response (RR 0.15, 95%CI 0.02-1.05). Adverse events were not reported per patient. The quality of evidence was low to very low using GRADE methodology.<h4>Conclusions</h4>Data supporting the use of Cannabis for the management of IBD are extremely limited. Further well-designed studies are needed before any positive conclusions regarding Cannabis use can be drawn.