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This study was put on clinical hold with the FDA prior to beginning enrollment due to insufficient preclinical evidence.
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For this quantitative study, the investigators will collect data on human safety and side-effects of Cannabichromene (CBC) and whether CBC reduces blood inflammatory markers and Rheumatoid Arthritis (RA) disease activity. The participants will participate in an ABAB design with 2 doses of CBC across the A phases. They will attend 5 in-person clinic visits where they will have physical evaluations, complete self-report forms, and have blood drawn for the following tests: hs-CRP, ESR, IL-6, TNF, Complete Blood Count [CBC], and CMP.
Due to their anti-inflammatory effects, cannabinoids have been considered as a potential therapy for the treatment of rheumatic diseases in humans. However, there is not yet significant evidence for the efficacy of cannabinoid-based treatments for rheumatoid arthritis, even though it is included in the list of eligible conditions for medical cannabis in Canada and many US states. In this study, the investigators propose to examine the safety and human behavioral pharmacology of CBC:
No statistical hypotheses have been developed for Aims 1 and 2 as they are descriptive in nature. Aim 3 has the statistical hypothesis embedded within it. These are reiterated below:
Aim 1: Assess human safety of CBC through a count of the number of treatment-related adverse events experienced by participants. This is a descriptive aim and therefore does not have an associated hypothesis.
Aim 2: Assess human safety of CBC through measurement of blood markers indicating organ function. This is a descriptive aim wherein the investigators will provide a qualitative description of changes in blood markers during treatment; it therefore does not have an associated hypothesis.
Aim 3: Determine if CBC reduces blood inflammatory markers and overall rheumatoid arthritis disease activity (as measured by the DAS28), across 2 dosages (400mg and 600mg CBC daily), each administered for an 8-week period. The investigators hypothesize that CBC will yield lower levels of inflammatory markers and overall disease activity during the treatment period and that levels of inflammatory markers will return to baseline at the 2-week follow-up for both of the doses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group 1 | Active Comparator | Participants will be administered dose one (400mg CBC daily) for eight weeks, and at visit three they will receive dose two (600mg CBC daily) and will take it for eight weeks, concluding the study with another two-week washout period. |
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| Study Group 2 | Active Comparator | Participants will be administered dose one (600mg CBC daily) for eight weeks, and at visit three they will receive dose two (400mg CBC daily) and will take it for eight weeks, concluding the study with another two-week washout period. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cannabichromene | Drug | Participants will be assigned (using block randomization) to begin with one of the two study doses of CBC (400mg or 600mg). Participants will be blinded to dose. They will be asked to take half of their dose in the morning and half in the evening. Participants will be administered dose one for eight weeks. After this, participants will have a two-week timeframe where they will be asked not to take any study medication and to continue refraining from cannabis use, thus providing a washout period. Then, at visit three, they will receive dose two and will take it for eight weeks, concluding the study with another two-week washout period. At each clinic visit participants will complete assessments (self-report and physical examination), urine, and blood samples. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Observed Adverse Events | Observed Adverse events | 20 Weeks |
| Incidence of Serious Adverse Events | Observed Serious adverse events | 20 Weeks |
| Incidence of Side-Effects Reported by Participants | Participant self-report of side-effects | 20 Weeks |
| Description of Safety Focused Blood Markers (CMP) | Safety focused blood marker levels aggregated through Comprehensive Metabolic Panel (CMP) during the treatment and post treatment phases. | 20 Weeks |
| Description of Safety Focused Blood Markers (CBC) | Safety focused blood marker levels aggregated through Complete Blood Count (CBC) during the treatment and post treatment phases. | 20 Weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With CBC Treatment-Related Reduction of RA Disease Activity as Assessed by DAS28. | Overall Rheumatoid Arthritis disease activity as assessed by the DAS28 (Disease Activity Score in 28 joints) tool across 2 dosages (400mg and 600mg daily), administered for 8 weeks per dose. | 20 Weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Crystal L Smith, PhD | Assistant Professor | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Washington State University | Spokane | Washington | 99202 | United States |
Deidentified and summarized participant data will be available to other researchers upon request. No IPD will be available due to the focused recruitment strategy, in an effort to provide protection to participants identities.
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| C010695 | cannabichromene |
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Participants will be randomized to begin with one of two study doses (400mg or 600mg daily) using a block randomization schedule.
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Participants will be blinded to dose but will know they are all getting active product.
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| Number of Participants With CBC Treatment-Related Reduced Inflammatory Blood Markers as Assessed by hs-CRP, ESR, IL-6, and TNF Tests. |
This will be measured across 2 dosages (400mg and 600mg daily), administered for 8 weeks per dose. This will be determined through the collection of inflammation focused blood marker levels during the treatment and post treatment phases: (High sensitivity C-reactive protein (hs-CRP); Erythrocyte Sedimentation Rate (ESR); Interleukin-6 (IL-6); Tumor Necrosis Factor (TNF) ) |
| 20 Weeks |
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |