In this period of uncertainty, many have asked whether cannabis could be used in the battle against the virus. While some initial positive results have been found in the lab, it is too early to tell whether cannabinoids will be effective in larger trials.
Background
Firstly, there is solid reasoning behind the hypothesis that cannabis and its constituent cannabinoids like CBD and THC could be used to treat the symptoms of COVID-19. Key to the hypothesis is the fact that the deaths associated with the virus are thought to occur in large part due to the body’s own immune response being overly reactive. When the body has this overreacting immune system, such as in severe cases of COVID-19, the resulting inflammation can harm the body’s own tissues, such as lung tissue where respiratory failure can occur.
Research has shown that THC and CBD can alter the body’s inflammatory response and help avert inflammatory damage being done to tissues and organs. In fact, cannabinoids regulate the exact same inflammatory proteins responsible for some of the damage occurring in COVID-19 cases. However, there is a suggestion that cannabinoids can reduce the immune response too much, and smoking of any kind is a possible risk factor for worsening symptoms, so, at this point, patients must exercise caution.
Before the leap is made to promote or reject cannabinoids as a treatment for COVID-19, the medicines must be tested thoroughly for safety and effectiveness, which is where clinical trials come in.
Source: Prohibition Partners, FDA, WHO, ClinicalTrials.gov, media sources
The Evidence
To assert that cannabis or cannabinoids can be used as a treatment for COVID-19, it is necessary for the medicines to be shown to be effective in reducing the symptoms or presence of the virus in a large and diverse group of patients who have COVID-19. To date, this has not occurred.
By searching databases such as ClinicalTrials.gov, the World Health Organization, the FDA and news outlets, we have identified 16 groups who are working to develop therapies for COVID-19 using cannabis or cannabinoids. Ten groups are still in the planning or early research phase without any results produced yet. While two of these studies showed preliminary positive data in-vitro, they were not complete at the time of writing.
Just two complete studies showed positive results and both were in mice models of COVID-related symptoms.
- One study showed that THC protects the lungs from overactive immune responses similar to those caused by COVID-19.
- The other study showed a similar response when testing CBD.
Four studies are scheduled to test the effectiveness of cannabinoids on COVID-19 in human patients in the near future: Studies testing the effects of CBD and cannabis in human patients.
Studies testing the effects of CBD and cannabis in human patients
Source: Prohibition Partners, Clinical Trials databases, media sources
To date, none of the four have produced results. Furthermore, it is not certain that positive results in these trials would convince large bodies such as the FDA in the US or the EU’s European Medicines Agency to approve the treatments for their inhabitants. That would require studies at more locations and with more patients. Until trials involving relatively large numbers of human patients are complete, it is impossible to say whether cannabinoids offer an effective treatment.
MGC Pharmaceuticals at late-stage clinical trials with ArtemiC
Meanwhile, other cannabis firms have already pivoted (or partly at least) to deal with the pandemic, such as AXIM Biotechnologies who is using its resources to develop rapid COVID testing kits. Others are leveraging their knowledge of plant-based medicines and the human immune system to create novel therapies that don’t rely on cannabinoids. MGC Pharmaceuticals is the furthest ahead of any cannabinoid company in developing a treatment, having already made it to phase II human patient trials for COVID-19 with its non-cannabinoid-containing food supplement, ArtemiC. The spray consists of plant extracts, including artemisinin, curcumin, boswellia serrata, and ascorbic acid, which have anti-inflammatory and immunomodulatory properties. Preliminary results from the first ten patients of the phase II clinical trial have shown significant clinical benefits in patients treated with ArtemiC compared to placebo, with no record of any adverse events to date.
If positive results are obtained from the remaining participants, this would bode very well for ArtemiC moving on to phase IIb and towards market approval, which would represent potentially the largest contribution to COVID-19 treatments for any cannabis company to date.
Conclusion
So, is it right to say that cannabis can be used to treat COVID-19? No, not yet. While the hypothesis makes sense, and preliminary results are good, it is still far too early to say definitively that cannabis or its components are effective at fighting the cause or symptoms of the disease and whether they outperform competing therapies. Preliminary results in models of the disease in cell culture or animal models can never be assumed to translate to efficacy in human patients without further trials. It will likely take at least six months, if not a year, before medicines from leading companies such as Tetra-Bio Pharma progress to late-stage clinical trials and further to market.
Those companies currently developing therapies and tests for COVID-19 are benefiting from increased funding opportunities and a streamlined FDA approvals process for drugs potentially useful in treating COVID-19. For example, Avicanna are benefitting from Canadian government funded Mitacs Accelerate Programme for COVID-19 treatments. Firms like Avicanna have never had a better chance to get their products approved in an efficient and timely manner. Any such approvals for COVID-19 may make it more likely that these medicines will be approved for an expanded set of conditions even after the pandemic has passed. This eventual approval would benefit not only those companies but also the wider industry whereby cannabis is being recognised for the useful and even essential medicinal properties it contains. To further encourage this trend, and to bolster the trust of consumers and medical practitioners, claims on what cannabis can and cannot treat must always be evidence-based.
For more information on how cannabis is being used in the world of medicine and pharmaceuticals, see Prohibition Partners’ upcoming report on Cannabis in Pharmaceuticals.
For the most in-depth information and support, contact the Prohibition Partners consultancy team at info@prohibitionpartners.com.
