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IACM-Bulletin of May 12, 2019
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IACM — Highlights of the Conference on 31 October-2 November 2019 in Berlin
The IACM Board of Directors is happy to announce that the programme of the 10th IACM Conference on Cannabinoids in Medicine will include talks by outstanding speakers.
Arno Hazekamp (The Netherlands): The Trouble with CBD Oil
Bonni Goldstein (USA): Cannabis for Children: A Pediatrician's Experience
Christian Kessler (Germany): Cannabis treatment under the legal situation in Germany
Daniela Eigenmann (Switzerland): History on medical cannabis
Daniele Piomelli (USA): Potential clinical applications of endocannabinoid degradation inhibitors
Donald Abrams (USA): Medical Uses of Cannabis and Cannabinoids: Lessons Learned from Real World Studies
Ethan Russo (Spain/USA): Cannabis Pharmacology: Untapped Potential
Franjo Grotenhermen (Germany): How to avoid Interactions and Side Effects
Guillermo Velasco (Spain): Cannabis and cancer treatment
Ilya Reznik (Israel): The medical use of cannabis in the elderly
Javier Fernández-Ruiz (Spain): Towards a cannabinoid-based neuroprotective therapy for neurodegenerative disorders
José Alexandre de Souza Crippa (Brazil) : CBD
Ken Mackie (USA): An introduction to the endocannabinoid system
Kirsten Müller-Vahl (Germany): Effects of THC, CBD and cannabis: different or all the same?
Mark Ware (Canada): Medical uses in pain
Roger Pertwee (UK): Pharmacological findings that reveal potential therapeutic uses for cannabinoids
Tamas Biro / Attila Olah (Hungary): Medical uses in dermatology
Ziva Cooper (USA): Cannabis and the opioid crisis
There will be also a panel of experts to discuss different approaches to manage the treatment of a new patient with cannabis-based medicines: “My first patient”. A panel of patients from different countries will offer the patient´s perspective. The conference language will be English. The first day is dedicated to an introductory overview for beginners and there will be simultaneous translation into German.
Science/Human — CBD extracts effective against seizures associated with tuberous sclerosis according to large study
GW pharmaceuticals announced positive results of a placebo-controlled Phase 3 clinical trial of Epidiolex, a CBD rich cannabis extract, in the treatment of seizures associated with Tuberous Sclerosis Complex, a rare and severe form of childhood-onset epilepsy.
In this trial, Epidiolex met its primary endpoint, which was the reduction in seizure frequency compared to baseline of the Epidiolex group vs placebo. Results for both the 25 and 50 mg/kg/day dose groups were similar, with seizure reductions of 48.6% and 47.5% from baseline respectively, vs 26.5% for placebo. “The positive outcome in this trial of Epidiolex in patients with Tuberous Sclerosis Complex expands both our knowledge of this newly available medicine and its potential utility beyond the current indications,” stated Dr Elizabeth Thiele, Director of the Herscot Center for Tuberous Sclerosis Complex at Massachusetts General Hospital, Professor of Neurology at Harvard Medical School and the lead investigator of the trial.
News in brief
Africa — Countries that intend to legalise cannabis in the coming years
Within the coming years there may be 9 countries to legalise the medical or recreational use of cannabis: South Africa, Zimbabwe, Lesotho, Nigeria, Morocco, Malawi, Ghana, Eswatini (former Swaziland) and Zambia. Some of them have already took major steps.
Science/Human — CBD had no effect on psychomotor impairment by THC
In a simulated driving test with 14 healthy volunteers there was no significant effect of CBD on impairment by THC. Participants inhaled 125 mg of cannabis with 11% THC and less than 1% CBD and at another time the same amount of cannabis with 11% THC and 11% CBD. Authors wrote that subjective “drug effects (e.g., "stoned") and confidence in driving ability did not vary with CBD content.” Peak blood plasma THC concentrations were higher following THC/CBD equivalent cannabis relative to THC-dominant cannabis, “suggesting a possible pharmacokinetic interaction.”
Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Australia.
Arkell TR, et al. Psychopharmacology (Berl). 2019 May 1.[in press]
USA — Harvard Medical School receives 4.5 million dollars for cannabinoid research
Charles R. Broderick, an alumnus of Harvard University and MIT, has made gifts to both alma maters to support fundamental research into the effects of cannabis on the brain and behavior. The total gift of 9 million dollars (4.5 million to each institution) represents the largest donation to date to support independent cannabinoid research.
Press release from Harvard Medical School of 30 April 2019
Portugal — First medical cannabis production farm
The Portuguese city of Cantanhede now hosts the country’s first medical cannabis production farm. Covering 2.4 hectares in a biotechnology park just outside Cantanhede, Tilray’s site was given the green light by Portugal’s regulator Infarmed in 2017.
New Zealand — Referendum on cannabis use by adults in 2020
The Government has announced details of how New Zealanders will choose whether or not to legalise and regulate cannabis, said Justice Minister Andrew Little. “There will be a clear choice for New Zealanders in a referendum at the 2020 General Election. Cabinet has agreed there will be a simple Yes/No question on the basis of a draft piece of legislation.
Government information of 7 May 2019
USA — Washington allows the medical use of cannabis on school grounds
The new law explicitly permits parents or guardians "to administer marijuana-infused products to the student while the student is on school grounds." It also mandates that school districts "permit a student [who is a qualified medical cannabis patient] to consume marijuana-infused products ... on school grounds, aboard a school bus, or while attending a school-sponsored event."
Canada/Germany — Canopy Growth buys cannabinoid sector of Bionorica
Canopy Growth is moving further into Europe after signing a 342.9 million US dollar deal to buy C3 Cannabinoid Compound, a German company that specializes in cannabinoid-based medical therapies used by European physicians. The company’s main medicinal offering is dronabinol, the international nonproprietary name of natural cannabinoid delta-9-THC.last month. Aurora Cannabis and Aphria were among the three companies selected by the German government to cultivate and distribute medical pot in Germany.
Science USA — Cannabis used in US research differs genetically to the varieties people smoke
The cannabis that’s used for research in the United States is genetically different to the cannabis people are smoking, says a recent study. The finding suggests that research investigating the plant’s biological effects might not completely replicate the experience of people using commercially available strains ― something researchers have long suspected.
Reardon S. Nature. 2019;569(7755):172
Science/Animal — CBD may reduce aggressive behaviour associated with some psychiatric diseases
A study with mice suggests, that CBD may reduce aggressive behaviour and this effect may be mediated by the 5-HT1A receptor. Authors concluded that “CBD may be therapeutically useful to treat aggressive behaviors that are usually associated with psychiatric disorders.”
Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Brazil.
Hartmann A, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2019:109637[in press]
Science/Human — CBD and palmitoylethanolamine may be helpful in inflammatory bowel disease
A randomized, double-blind, controlled-trial assessed the effect of palmitoylethanolamine (PEA) or CBD on the absorption of lactulose and mannitol in humans taking 600 mg of aspirin. In vivo, aspirin caused an increase in the absorption of lactulose and mannitol, which were reduced by PEA or CBD. Authors concluded that both substances “reduce permeability in the human colon. These findings have implications in disorders associated with increased gut permeability, such as inflammatory bowel disease.
Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK.
Science/Animal — High doses of CBD may have negative effects on the liver
Mice treated with high oral doses of CBD (up to 2560 mg per kilogram bodyweight) showed signs of liver toxicity. Authors noted that their observation may be relevant to patients receiving up to 20 mg CBD per kilogram bodyweight. They noted that “involvement of numerous pathways associated with lipid and xenobiotic metabolism raises serious concerns about potential drug interactions as well as the safety of CBD.”
Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Ewing LE, et al. Molecules. 2019;24(9).
Science/Human — Enzymes involved in the degradation of THC
Scientists investigated the involvement of liver enzymes in the degradation of THC. CYP2C9 pathway was the major pathway for depletion of THC and formation of 11-OH-THC. The remaining THC degradation pathway was attributed to CYP2D6. 11-OH-THC was depleted by UGTs , CYP3A4 and CYP2C9 .
University of Washington, USA.
Patilea-Vrana GI, et al. Drug Metab Dispos. 2019 May 2.[in press]
Science/Human — CBD may influence the blood concentrations of antiepileptic drugs
Researchers investigated the effects of oral CBD in 61 patients aged 1 to 17 years on blood concentrations of the antiepileptic drug clobazam. Approximately 2-6 days of twice-daily dosing provided steady-state concentrations of CBD. Concomitant administration of clobazam with 40 mg/kg/day of CBD resulted in a 2.5-fold increase in mean CBD blood concentration. Mean plasma clobazam concentrations were 1.7- and 2.2-fold greater in patients receiving clobazam concomitantly with 40 mg CBD per kg/day compared with 10 mg/kg/day and 20 mg/kg/day.
University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN, USA.
Wheless JW, et al. CNS Drugs. 2019 May 2. [in press]
Science/Human — Efficacy of CBD in epilepsy is correlated to blood levels
In an open study with 56 adults and 44 children there was a positive correlation between CBD doses, CBD blood concentrations and reduction of seizure frequency in epilepsy. After daily doses of 5 to 50 mg per kilogram bodyweight blood plasma levels ranged from 7 to 1200 ng/mL.
Department of Neurology, University of Alabama at Birmingham, USA.