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Weekly Cannabis News

December 12th-19th, 2021

Cannabidiol (CBD) Inhalation Reduces Brain Tumor Glioblastoma (GBM) Size in Rodent Studies

The use of CBD inhalation may represent an interesting and novel therapeutic approach to treat GBM, a new study says

Researchers at Augusta University, Georgia, published a study aiming to investigate the potential therapeutic effects of CBD in inhibiting GBM tumor growth using a well-established orthotopic murine model. [1] This model involves seeding of specific tumor cell lines into the corresponding tissue in animal models, allowing researchers to not only assess tumor development but also evaluate drug efficacy in a preclinical tumor model mimicking the disease process in humans.

As opposed to ∆9-tetrahydrocannabinol (∆9-THC), CBD is commonly associated with an absence of euphoric-like effects with a potential therapeutic use in a wide array of diseases.

Using a mix of experimental techniques, the team found that CBD inhalation limited tumor growth while altering key regulatory pathways within the tumor microenvironment (TME) including important players such as P-selectin, apelin, interleukin-8 and indoleamine 2,3 dioxygenase.

The Use of Medical Cannabis to Relieve Severe Cases of Epilepsy in Children

Whole plant cannabis administration reduced seizure frequency in children with severe treatment resistant epilepsy.

A team of researchers at the Imperial College London investigated whether medical cannabis can be used in children 13 years or younger (mean age: 6.2 years old) with severe treatment-resistant epilepsy who have failed on multiple traditional medications including Epidyolex treatment. [2]  

In 2019, Epidyolex (GW Pharmaceuticals) became the first and only approved prescription-based CBD medication for the treatment of seizures associated with Lennox-Gastaut and Dravet syndromes. [3]

In this study, patients received whole-plant cannabis products containing a combination of terpenes and flavonoids, responsible for the color, taste, and aroma of the plant as well as minor phytocannabinoids. The authors reported mean daily THC and CBD doses of 5.15 mg and 171.8 mg, respectively, and found an 86% reduction in seizure frequency across all 10 patients with no adverse events.

They concluded that: “we believe that our data on whole-plant medical cannabis in childhood-onset severe treatment-resistant epilepsy, provides evidence to support its introduction into the National Health Service within current National Institute for Health and Care Excellence prescribing guidelines. Such a move would be hugely beneficial to the families, who in addition to having the psychological distress of looking after their chronically ill children, have also to cover the crippling financial burden of their medication”.

Malta Becomes the First Country in the European Union (EU) to Legalize Recreational Cannabis

Recreational cannabis is now legal in Malta.

Malta, an archipelago in the central Mediterranean Sea located between Sicilia and North Africa, is set to become the first nation in the EU to move forward with the legalization of cannabis use and growth for recreational purposes.

In the New York Times, the Malta government said that “the new law was aimed at ending the criminalization of people for smoking the drug and at reducing criminal trafficking”. [4] President George Vella signed the legislation on December 18th. [5] Under the legislation of Owen Bonnici, Minister for Education & Employment in the Parliament of Malta, a set of new laws that would help regulate cannabis use will be implemented including allowing consumers of age 18 and up to carry up to seven grams of cannabis, grow up to four plants in their apartments while keeping up to 50 grams of dried cannabis at home.  However, possession of more than seven grams but less than 28 grams by an adult will be punishable by a €50 to €100 fine without the threat of jail time or a criminal record.

Pfizer Inc. Acquires Arena Pharmaceuticals, Inc. and Makes its Entry into the Medical Cannabis Industry

Pfizer Inc steps into the Medical Cannabis World

In a press release, Pfizer announced that they have entered a definitive agreement with Arena Pharmaceuticals, an American clinical stage biopharmaceutical company developing potential treatment for several immuno-inflammatory diseases for $100 per share in an all-cash transaction for a total equity value of approximately $6.7 billion. [6]  As such, they have officially joined the medical cannabis sector.  

One of Arena’s pipeline products in Olorinab (ADP371), an investigational, oral, peripherally acting, highly selective, full agonist of the cannabinoid receptor 2 (CBR2), is currently in clinical development for the treatment of inflammatory bowel disease (IBD) such as Crohn’s Disease and irritable bowel syndrome (IBS)-associated abdominal pain. [7],[8]

Cannabis Use May Potentially Impact Drug Interactions

A recent study shows that one needs to be careful when combining cannabis with prescription medications

A team of researchers at Washington State University investigated the potential drug-drug interactions of major cannabinoids and their metabolites on a major family enzyme called cytochrome P450s (CYP), responsible for drug metabolism. [9]

They found that the major THC metabolites, 11-hydroxy-∆9-THC and 11-nor-9-carboxy-∆9-THC-glucoronide inhibited several key P450 enzymes including CYP2B6, CYP2C9, and CYP2D6.  This is a very relevant investigation as this is the first study to perform comprehensive analysis of the potential inhibitory activities of major cannabinoids and THC metabolites against major human hepatic CYP450 enzymes.  

The authors concluded: “further investigations into the nature of inhibition of cannabinoids and their metabolites against specific agents will help to clarify the precise mechanism of in vivo cannabis-drug interactions.”

With the increasing number of US states legalizing cannabis for recreational and medical purposes, more individuals are using cannabis-derived products along with other prescription medications thinking it may not cause any harm when combining them.

References

[1] Khodadadi H, Salles EL, Alptekin A, et al. Inhalant Cannabidiol Inhibits Glioblastoma Progression Through Regulation of Tumor Microenvironment. Cannabis Cannabinoid Res 2021. DOI: 10.1089/can.2021.0098

[2] Zafar R, Schlag A, Phillips L, et al Medical cannabis for severe treatment resistant epilepsy in children: a case-series of 10 patients BMJ Paediatrics Open 2021;5: e001234. doi: 10.1136/bmjpo-2021-001234

[3] https://ir.gwpharm.com/news-releases/news-release-details/gw-pharmaceuticals-receives-european-commission-approval

[4] https://www.nytimes.com/2021/12/15/world/europe/malta-eu-marijuana-legalize.html

[5] https://lovinmalta.com/malta/cannabis-is-officially-legal-president-george-vella-signs-cannabis-bill/

[6] https://www.pfizer.com/news/press-release/press-release-detail/pfizer-acquire-arena-pharmaceuticals

[7] Olorinab in IBS-C and IBS-D (CAPTIVATE), NCT04043455

[8] Tolerability, Pharmacokinetics, and Efficacy of ADP371 in Participants with Crohn’s Disease Experiencing Abdominal Pain, NCT03155945

[9] Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. DOI: 10.1124/dmd.121.000442

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Author Yoel H. Sitbon

Yoel is a Medical Writer in the Medical Content division at Csequence. His scientific expertise is in Neuroscience (neural mechanisms behind drug addiction) and Molecular & Cellular Pharmacology (molecular mechanisms behind mutations induced cardiovascular diseases). Yoel has over five years of scientific writing experience as evidenced by 8 peer-reviewed publications in scientific journals. He is an effective oral communicator having presented his PhD thesis work at many biomedical conferences nationally. He also has strong mentorship and leadership experience. Yoel has a B.S in Neuroscience at the University of California, Los Angeles and a Ph.D. in Molecular & Cellular Pharmacology at the University of Miami, Miller School of Medicine.

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