Topical cannabis‐based medicines – A novel adjuvant treatment for venous leg ulcers: An open‐label trial

Venous leg ulcers are highly prevalent lower limb integumentary wounds that remain challenging to heal despite the use of evidence‐based compression therapies. A multitude of adjuvant treatments has been studied but none have demonstrated enough efficacy to gain adoption into treatment guidelines. G...

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Bibliographic Details
Published in:Experimental dermatology 2021-09, Vol.30 (9), p.1258-1267
Main Authors: Maida, Vincent, Shi, Runjie Bill, Fazzari, Francesco Gabriele Tatangelo, Zomparelli, Lydia
Format: Article
Language:English
Subjects:
Adjuvant therapy
Administration, Topical
Aged
Aged, 80 and over
Cannabis
Clinical trials
Combined Modality Therapy
Compression
Compression Bandages
Compression therapy
Endocannabinoid System
Female
Humans
integumentary wounds
Leg
Leg Ulcer - therapy
Leg ulcers
Male
Marijuana
Medical Marijuana - therapeutic use
Middle Aged
Patients
peri‐wound tissues
Topical Cannabis‐Based Medicines
Ulcers
Varicose Ulcer - therapy
venous leg ulcers
wound bed
wound closure
Wound Healing - drug effects
Wounds
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Summary:Venous leg ulcers are highly prevalent lower limb integumentary wounds that remain challenging to heal despite the use of evidence‐based compression therapies. A multitude of adjuvant treatments has been studied but none have demonstrated enough efficacy to gain adoption into treatment guidelines. Global attention on Cannabis‐Based Therapies is increasing and has been driven by quantum scientific advancements in the understanding of the endocannabinoid signalling system. Topical Cannabis‐Based Medicines represent a novel treatment paradigm for venous leg ulcers in terms of promoting wound closure. Fourteen complex patients with sixteen recalcitrant leg ulcers were treated with Topical Cannabis‐Based Medicines in conjunction with compression bandaging, every second day, to both wound bed and peri‐wound tissues. The cohort had a mean age of 75.8 years and was medically complex as reflected by a mean M3 multimorbidity index score of 2.94 and a mean Palliative Performance Scale score of 67.1%. Complete wound closure, defined as being fully epithelialized, was achieved among 11 patients (79%) and 13 wounds (81%) within a median of 34 days. All three remaining patients demonstrated progressive healing trends but were lost to follow‐up. The treatments were well tolerated, and no significant adverse reactions were experienced. The rapid wound closure of previously non‐healing venous leg ulcers among elderly and highly complex patients suggests that Topical Cannabis‐Based Medicines may become effective adjuvants in conjunction with compression therapy. This may also indicate that they may have an even broader role within integumentary and wound management. Therefore, this treatment paradigm warrants being subjected to controlled trials.
ISSN:0906-6705
1600-0625
DOI:10.1111/exd.14395