Topical cannabis-based medicines – A novel paradigm and treatment for non-uremic/ calciphylaxis leg ulcers: An open label trial
Non-Uremic Calciphylaxis (NUC) is a rare condition that manifests as painful, non-healing open skin wounds with high likelihood of becoming infected, often in the legs. It also has a substantial 1-year mortality rate of 25%-40%. All five most frequently used treatments for this condition were invasive with multiple side effects, yet were found by a recent systematic review to fail to deliver significant benefit. For these reasons, novel therapies that are effective, safe, and non-invasive for NUC represents an urgent need.
The endocannabinoid system (ECS) is a signaling system of the body that is dysregulated within wound beds and surrounding wound tissues according to previous research. Interestingly, many constituents of the cannabis plant have been shown to interact with the ECS in skin to promote wound closure and pain relief.
Recently, two patients with NUC of longer than 6 months durations were enrolled in a clinical cohort study using topical cannabis-based medicines (TCBMs). Complete wound closure was achieved in both patients after around 11 weeks, and no analgesics were required after approximately 9 weeks. The treatments were well tolerated with no adverse reactions.
These positive results suggested that not only are TCBMs new treatment for the challenging wounds in NUC, but they may also have a broader role in the management of many types and classes of wounds. However, these findings were preliminary as the study had a small sample size, lacked proper controls and randomized procedure. Therefore, besides making valuable clinical observations and conclusions, the authors also acknowledged the need for larger, controlled clinical trials before a systematic therapeutic strategy can be established.