Are Cannabis and Cannabinoids a Valid Treatment Option in Patients with Rheumatic Diseases? A narrative review.

Perrot S. · Joint bone spine · 2026

**Background & Methods** This narrative review evaluated the efficacy and safety of cannabis and cannabinoids in rheumatic disease patients by systematically searching literature published between 2000 and 2026. The analysis included 17 preclinical studies on mechanisms of action and 43 clinical studies (randomized trials, observational studies, and systematic reviews) across multiple rheumatic conditions. **Key Findings** • Strongest evidence for cannabinoid efficacy was observed in fibromyalgia (28 studies identified), with most trials reporting improvements in pain and sleep quality; limited evidence supported use in rheumatoid arthritis (2 studies) and osteoarthritis (10 studies), with single studies identified for psoriatic arthritis and systemic sclerosis. • Most clinical studies reported short-term symptomatic benefits, particularly for pain reduction and sleep improvement across rheumatic diseases, though findings were inconsistent and heterogeneous across different cannabinoid formulations. • The authors concluded that current evidence is insufficient to support routine clinical use or formal recommendations for cannabinoid-based therapies in rheumatic disease management. **Dosage & Administration** Not reported. The review noted heterogeneous formulations across studies, limiting standardized dosing recommendations. **Safety & Adverse Effects** Globally, cannabinoids were reported to be well tolerated across the included studies. Specific adverse effects were not detailed in the abstract. **Evidence Quality** Evidence quality was limited by multiple methodological constraints: small sample sizes, heterogeneous cannabinoid formulations and administration routes, inconsistent outcome measures, and risk of bias across studies. The predominance of fibromyalgia research (28 of 43 clinical studies) creates an imbalanced evidence base with minimal data for other rheumatic conditions. While preclinical studies (n=17) provided mechanistic insights into cannabinoid actions, clinical translation remains unclear. The narrative review design, while comprehensive in scope, is inherently subject to reviewer bias. Overall, the evidence represents low-to-moderate quality, with most studies being underpowered and lacking rigorous blinding and control mechanisms necessary for definitive clinical recommendations in rheumatic disease management.

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