Effect of Vaporized Cannabis on Exertional Breathlessness and Exercise Endurance in Advanced Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial.

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  • Additional Information
    • Source:
      Publisher: American Thoracic Society Country of Publication: United States NLM ID: 101600811 Publication Model: Print Cited Medium: Internet ISSN: 2325-6621 (Electronic) Linking ISSN: 23256621 NLM ISO Abbreviation: Ann Am Thorac Soc Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : American Thoracic Society, [2013]-
    • Subject Terms:
      Bronchodilator Agents*/administration & dosage ; Bronchodilator Agents*/pharmacokinetics ; Cannabidiol*/administration & dosage ; Cannabidiol*/pharmacokinetics ; Dronabinol*/administration & dosage ; Dronabinol*/pharmacokinetics ; Lung*/drug effects ; Lung*/physiopathology ; Pulmonary Disease, Chronic Obstructive*/diagnosis ; Pulmonary Disease, Chronic Obstructive*/drug therapy ; Pulmonary Disease, Chronic Obstructive*/physiopathology; Dyspnea/*drug therapy; Administration, Inhalation ; Adult ; Biological Availability ; Double-Blind Method ; Dyspnea/etiology ; Exercise Test/methods ; Female ; Humans ; Male ; Nebulizers and Vaporizers ; Physical Endurance/drug effects ; Psychotropic Drugs/administration & dosage ; Psychotropic Drugs/pharmacokinetics ; Respiratory Function Tests/methods ; Treatment Outcome
    • Abstract:
      Rationale: A series of studies conducted approximately 40 years ago demonstrated an acute bronchodilator effect of smoked cannabis in healthy adults and adults with asthma. However, the acute effects of vaporized cannabis on airway function in adults with advanced chronic obstructive pulmonary disease (COPD) remain unknown.
      Objectives: To test the hypothesis that inhaled vaporized cannabis would alleviate exertional breathlessness and improve exercise endurance by enhancing static and dynamic airway function in COPD.
      Methods: In a randomized controlled trial of 16 adults with advanced COPD (forced expiratory volume in 1 second [FEV 1 ], mean ± SD: 36 ± 11% predicted), we compared the acute effect of 35 mg of inhaled vaporized cannabis (18.2% Δ 9 -tetrahydrocannabinol, <0.1% cannabidiol) versus 35 mg of a placebo control cannabis (CTRL; 0.33% Δ 9 -tetrahydrocannabinol, <0.99% cannabidiol) on physiological and perceptual responses during cardiopulmonary cycle endurance exercise testing; spirometry and impulse oscillometry at rest; and cognitive function, psychoactivity, and mood.
      Results: Compared with CTRL, cannabis had no effect on breathlessness intensity ratings during exercise at isotime (cannabis, 2.7 ± 1.2 Borg units vs. CTRL, 2.6 ± 1.3 Borg units); exercise endurance time (cannabis, 3.8 ± 1.9 min vs. CTRL, 4.2 ± 1.9 min); cardiac, metabolic, gas exchange, ventilatory, breathing pattern, and/or operating lung volume parameters at rest and during exercise; spirometry and impulse oscillometry-derived pulmonary function test parameters at rest; and cognitive function, psychoactivity, and mood.
      Conclusions: Single-dose inhalation of vaporized cannabis had no clinically meaningful positive or negative effect on airway function, exertional breathlessness, and exercise endurance in adults with advanced COPD. Clinical trial registered with www.clinicaltrials.gov (NCT03060993).
    • Comments:
      Comment in: Ann Am Thorac Soc. 2018 Oct;15(10):1137-1138. (PMID: 30272498)
      Comment in: Ann Am Thorac Soc. 2019 Mar;16(3):397. (PMID: 30712357)
      Comment in: Ann Am Thorac Soc. 2019 Mar;16(3):396-397. (PMID: 30712358)
      Comment in: Ann Am Thorac Soc. 2019 Mar;16(3):398. (PMID: 30712361)
    • Grant Information:
      201410GSD-347900-243684 Canada CIHR
    • Contributed Indexing:
      Keywords: chronic obstructive pulmonary disease; dyspnea; functional capacity; marijuana
    • Molecular Sequence:
      ClinicalTrials.gov NCT03060993
    • Accession Number:
      0 (Bronchodilator Agents)
      0 (Psychotropic Drugs)
      19GBJ60SN5 (Cannabidiol)
      7J8897W37S (Dronabinol)
    • Publication Date:
      Date Created: 20180728 Date Completed: 20191107 Latest Revision: 20191107
    • Publication Date:
      20240829
    • Accession Number:
      10.1513/AnnalsATS.201803-198OC
    • Accession Number:
      30049223