Conference Coverage

Cannabis tied to lower IBD mortality, hospital costs


 

AT ECCO 2023

Mortality rate, length of hospital stay, and cost of hospitalization all drop significantly in patients with inflammatory bowel disease (IBD) concurrently using cannabis, shows a study that supports wider availability of the substance for specified medical use.

Inpatient mortality dropped by more than 70% in those patients concurrently using cannabis for another indication, compared with those not taking the drug, while total cost of hospitalization dropped by more than $11,000.

The findings were presented as a poster by Neethi Dasu, DO, PGY 6 Gastroenterology Fellow, at Jefferson Health Hospital, N.J., at the annual congress of the European Crohn’s and Colitis Organization. Dr. Dasu worked with coinvestigator Brian Blair, DO, FACOI, Gastroenterology Program Director, IBD specialist, at the same hospital.

“This study reveals substantial benefits of cannabis in the management of patients with IBD,” Dr. Dasu said. “Not only do patients spend less time in hospital, but they also have a decrease in mortality and hospital cost, which can be significant for patients with IBD, a chronic condition, that often burdens them with high health care spend.”

The researcher also highlighted that with annual U.S. health care spending on IBD having increased significantly in recent years, getting patients well and out of the hospital in a timely manner is key and that “cannabis might help in this aim.”

Cannabis use is legalized in some U.S. states for medical treatment of several chronic, debilitating disorders, especially cancer. Currently, there is no direct Food and Drug Administration approval for use for IBD. “Utilizing it would be considered off-label and investigational,” Dr. Dasu pointed out.

Patients report cannabis, as a pain control treatment, is effective for acute flares and chronic IBD, said Dr. Dasu. “It is an excellent agent for pain control that is not a narcotic, as with opioids, which can cause dependence and addiction. These could ultimately harm patients in the long term,” she addedin an interview. “Opioids can also cause drowsiness and side effects, which harm a person’s quality of life.”

Patients with IBD using cannabis concurrently

Dr. Dasu and her coresearchers aimed to see if outcomes including mortality and pain could be modified with “a very accessible and cost-efficient agent that does not cause long term addiction or adverse events.”

She added that previous studies had evaluated the clinical response in patients with IBD and concomitant cannabis use, but that their study was novel because it looked at inpatient outcomes as well as overall hospital cost.

Dr. Dasu and colleagues analyzed data over the years 2015-2019, from the Nationwide Inpatient Sample (NIS), a large publicly available all-payer inpatient care database, which encompasses approximately 7 million inpatient hospitalizations annually in the United States.

All included patients had IBD, either ulcerative colitis or Crohn’s disease, were aged 18 years and over, and used cannabis for a concurrent indication.

Odds ratios were calculated for in-hospital mortality, average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics.

Of the 1,198,839 patients with IBD, 29,445 used cannabis for a different indication. Participants had an average age of 38.7 years.

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