Sickle Cell Disease Clinical Trial
Official title:
Cannabinoid-Based Therapy and Approaches to Quantify Pain in Sickle Cell Disease
Our primary objective is to assess whether inhaling vaporized cannabis ameliorates chronic
pain in patients with sickle cell disease (SCD). As these patients will all be on chronic
opioid analgesics, the investigators will also assess the possible synergistic affect between
inhaled cannabis and opioids. The investigators will also assess the clinical safety of the
concomitant use of cannabinoids and these opioids in patients with SCD by monitoring the
short-term side effects associated with combined therapy. Finally, the investigators will
evaluate the short-term effects of inhaled cannabis on markers of inflammation and disease
progression in patients with SCD.
Hypotheses are as follows:
1. Inhaled cannabis will significantly reduce chronic pain in patients with SCD.
2. Inhaled cannabis will significantly alter the short-term side effects experienced by
patients who take opioids for SCD.
3. Inhaled cannabis will significantly alter markers of inflammation and disease
progression in patients with SCD compared to placebo.
This is a proof-of-principle investigation of the safety and potential effectiveness of
inhaled vaporized cannabis when added to a stable analgesic regimen in sickle cell disease
(SCD) patients with chronic pain. The study will be comprised of two 5-day intervention
periods in the inpatient setting (the Clinical Research Center at SFGH), with completion of a
5-day daily pain diary prior to admission to establish an outpatient baseline. Participants
will be randomly assigned, in double-blind fashion, to treatment with (A) vaporized cannabis
with an approximately 1:1 ration of delta-9-tetrahydrocannabinol:cannabidiol or (B) vaporized
placebo. Those who receive treatment A during the first admission will receive treatment B in
the second, and those who receive treatment B during the first admission will receive
treatment A in the second. The two admissions will be spaced at least 14 days apart.
On Day 1 of each admission, subjects will provide blood samples for baseline markers of
inflammation and SCD disease progression. They will undergo assessments of pain, mood, and
quality of life. At 12 pm on Day 1, they will inhale vaporized study agent (equivalent to 1
cannabis/placebo cigarette) using the Volcano® vaporizer; on Days 2-4 they will inhale study
agent at 8 am, 2 pm, and 8 pm, and they will inhale their final dose on Day 5 at 8 am.
Subjects will continue their pre-study analgesic regimen while in the study. If additional
analgesia is required, supplemental therapy will be administered and the dose recorded. Pain
measurements by visual analogue scale will be obtained every 2 hours while subjects are
awake. On Day 5 a second set of blood samples for inflammation markers and disease
progression will be obtained, and subjects will again complete pain, mood, and quality of
life assessments.
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