Products that contain natural or synthetic THC or CBD come in many forms. These include the dried plant (herb or flower), edibles (brownies, cookies, candy), drinkables (coffee, tea, lemonade, soda), oils, tinctures (which are taken orally), sprays, and topical creams and gels.
There is only one currently ongoing study of medical marijuana for lupus. That study is looking at whether a potential new drug made from a synthetic cannabinoid can treat joint pain and swelling (inflammation) in people with lupus. The drug, which is called JBT-101 (lenabasum), doesn’t produce a high. Several smaller studies of other conditions involving the immune system have reported positive results with lenabasum.
What is medical marijuana?
Until more research is done, we don’t know if medical marijuana can help people with lupus. We don’t know whether it can provide relief from lupus symptoms, if it interacts with drugs used to treat these symptoms, or whether it can lessen the side effects of those drugs.
People have used medical marijuana for a variety of health conditions. But the FDA hasn’t approved medical marijuana as a safe and effective treatment for lupus – or for any medical condition or symptoms.
Medical marijuana is not approved by the U.S. Food and Drug Administration (FDA) to treat lupus or any other condition.
In 2018, Dr. Koumpouras joined a multi-site randomized clinical trial that aims to recruit 100 participants to examine whether a drug using a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) can help ease pain and inflammation in patients with lupus. Participants will receive Lenabasum or a placebo for almost three months and will continue to be monitored for pain and inflammation levels, as well as lupus disease activity. The study is ongoing, but Dr. Koumpouras anticipates that it will wrap up by early next year.
What these cannabinoids do when they bind to the receptors depends on which receptor is activated, and thus can produce effects ranging from the firing of neurotransmitters (the chemical messengers sent from the brain to the rest of the body) that alter mood, to reducing inflammation and promoting digestion.
So, our bodies have their own endocannabinoid system, but cannabinoids can also be found in nature, most abundantly in the marijuana plant. The two most well-known types of cannabinoids in the marijuana plant are THC (tetrahydrocannabinol) and CBD (cannabidiol). THC binds to both the CB1 and CB2 receptors, but the CB1 receptor seems to be responsible for many of the well-known psychoactive effects of marijuana, such as euphoria, increased heart rate, slower reaction times, and red eyes. CB2 receptor binding results in the production of a series of proteins that reduce inflammation. (These proteins are called “resolvins” because they appear to resolve inflammation.) The pharmacology of CBD at cannabinoid receptors is complex and highly variable, but CBD has been shown to activate the endocannabinoid system.
What is CBD?
Fotios Koumpouras, MD, is researching a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) to see if it can help ease pain and inflammation in patients with lupus.
“The landscape for treatment of lupus is a bit bleak,” says Fotios Koumpouras, MD, a rheumatologist and director of the Lupus Program at Yale Medicine. “A multitude of drugs have failed in the last 10 to 15 years. Most of the drugs we use are being repurposed from other conditions and are not unique to lupus. Many of them can’t be used during pregnancy, which is a problem because lupus mostly affects young women. All of these issues create the impetus to find new and more effective therapies.”
But these questions are why Dr. Koumpouras is focusing on a compound that, until recently, few have studied.
This is why he’s exploring a candidate for a new lupus treatment option: a molecule with a cannabinoid template structure that binds to cannabinoid receptors, the same receptors involved in the chemicals found in the marijuana plant.