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Cited by 340Cannabis and Cannabinoid ResearchPain Mechanisms and TreatmentsPain Management and Opioid Use

Analgesic Effect of the Synthetic Cannabinoid CT-3 on Chronic Neuropathic Pain: A Randomized Controlled Trial

Karst, Matthias, Salim, Kahlid, Burstein, Sumner, Conrad, Ingomar, Hoy, Ludwig, Schneider, Udo·2003·JAMA
DOI 10.1001/jama.290.13.1757
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Abstract

CONTEXT: 1',1'dimethylheptyl-Delta8-tetrahydrocannabinol-11-oic acid (CT-3), a potent analog of THC-11-oic acid, produces marked antiallodynic and analgesic effects in animals without evoking the typical effects described in models of cannabinoids. Therefore, CT-3 may be an effective analgesic for poorly controlled resistant neuropathic pain. OBJECTIVE: To examine the analgesic efficacy and safety of CT-3 in chronic neuropathic pain in humans. DESIGN AND SETTING: Randomized, placebo-controlled, double-blind crossover trial conducted in Germany from May-September 2002. PARTICIPANTS: Twenty-one patients (8 women and 13 men) aged 29 to 65 years (mean, 51 years) who had a clinical presentation and examination consistent with chronic neuropathic pain (for at least 6 months) with hyperalgesia (n = 21) and allodynia (n = 7). INTERVENTIONS: Patients were randomized to two 7-day treatment orders in a crossover design. Two daily doses of CT-3 (four 10-mg capsules per day) or identical placebo capsules were given during the first 4 days and 8 capsules per day were given in 2 daily doses in the following 3 days. After a washout and baseline period of 1 week each, patients crossed over to the second 7-day treatment period. MAIN OUTCOME MEASURES: Visual analog scale (VAS) and verbal rating scale scores for pain; vital sign, hematologic and blood chemistry, and electrocardiogram measurements; scores on the Trail-Making Test and the Addiction Research Center Inventory-Marijuana scale; and adverse effects. RESULTS: The mean differences over time for the VAS values in the CT-3-placebo sequence measured 3 hours after intake of study drug differed significantly from those in the placebo-CT-3 sequence (mean [SD], -11.54 [14.16] vs 9.86 [21.43]; P =.02). Eight hours after intake of the drug, the pain scale differences between groups were less marked. No dose response was observed. Adverse effects, mainly transient dry mouth and tiredness, were reported significantly more often during CT-3 treatment (mean [SD] difference, -0.67 [0.50] for CT-3-placebo sequence vs 0.10 [0.74] for placebo-CT-3 sequence; P =.02). There were no significant differences with respect to vital signs, blood tests, electrocardiogram, Trail-Making Test, and Addiction Research Center Inventory-Marijuana scale. No carryover or period effects were observed except on the Trail-Making Test. CONCLUSIONS: In this preliminary study, CT-3 was effective in reducing chronic neuropathic pain compared with placebo. No major adverse effects were observed.

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  • Ajulemic acid suppressed mixed forms of neuropathic pain as assessed with the visual analogue scale in the morning (3 hours after drug administration), but not in the afternoon (8 hours following drug administration).

    “A 21 patient study reported that ajulemic acid (CT-3) suppressed mixed forms of neuropathic pain, as assessed with the VAS, in the morning (3 hours after drug administration), but not in the afternoon (8 hours following drug administration).152”

    From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [152]

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Authors
Karst, M., Salim, K., Burstein, S., Conrad, I., Hoy, L., & Schneider, U.
Affiliations
Medizinische Hochschule Hannover (DE)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2003-10-01
Volume
290
Issue
13
Pages
1757
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.290.13.1757
OpenAlex
W1973788448
Cited by
340
References
14
Citations by year
2026: 6 · 2025: 7 · 2024: 4 · 2023: 19 · 2022: 12 · 2021: 7 · 2020: 15 · 2019: 9 · 2018: 15 · 2017: 5 · 2016: 12 · 2015: 10 · 2014: 12 · 2013: 13 · 2012: 12
FWCI
15.85
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
synthetic cannabinoids, chronic neuropathic pain, analgesic efficacy, allodynia, hyperalgesia, adverse effects, xerostomia, drug safety, placebo-controlled crossover trial, VAS pain score, Trail Making Test, dose-response relationship
MeSH terms
Adult, Chronic Disease, Double-Blind Method, Female, Humans, Hyperalgesia, Male, Middle Aged, Pain, Pain Measurement, Dronabinol, Cross-Over Studies, Analgesics, Non-Narcotic

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