P398 Cannabis induces clinical and endoscopic improvement in moderately active ulcerative colitis (UC)

Cannabis is frequently used by patients with UC, although it was never investigated in a controlled trial. We aimed to assess the effects of Cannabis in moderately active UC in a randomised placebo controlled trial. Patients with UC who did not respond to conventional medical treatment were randomised to receive two cigarettes of cannabis or placebo daily. Each cigarette contained 0.5 g of cannabis, corresponding to 11.5 mg THC. The placebo contained cannabis leaves from which THC was extracted. Disease activity (DAI), endoscopic findings and laboratory tests were assessed before and after 8 weeks of treatment. All other medication remained unchanged. Twenty-eight patients completed the study, mean age 33 (20–61), 17 males. The colitis was extended in 11 and left sided in 17 patients. During treatment the DAI decreased from 10 ± 3 to 4 ± 3.2 and from 10 ± 2.7 to 8 ± 2 (p < 0.01), while the Mayo endoscopic score decreased from a median of 2 (IQR = 2–2.5) to 1 (IQR 0–2) (p = 0.01) and from 2 (IQR = 2–2) to 2 (IQR 1.25–2) (p = 0.059) in the THC and placebo groups, respectively. The mean CRP changed from 0.8 ± 0.9 to 0.7 ± 1.2 and from 1.8 ± 1.9 to 1 ± 1.6 (mg/dl) (p = 0.5), whereas faecal Calprotectin changed from 135 ± 113 to 115 ± 103 and from 226 ± 100 to 229 ± 230 (mg/dl)in the THC and placebo groups, respectively (p = 0.7). No serious side effects were observed. Tetrahydrocannabinol-rich cannabis is safe and can induce clinical as well as endoscopic improvement in moderately active UC.