Efficacy and Safety of Cannabis Extracts for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis of Preclinical and Human Studies
In brief
Cannabis extracts showed no pain relief in four osteoarthritis trials
A systematic review of 26 studies found animal work suggests anti-inflammatory and analgesic effects, but four randomized trials in humans reported no improvement in pain, quality of life, or function. Adverse events were mild, and the clinical evidence remains too weak to recommend cannabinoids for osteoarthritis without further large trials.
- Journal
- Pain research & management (Q1)
- Published
- 1 January 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Bedru J Abafita, Ambrish Singh, Dawn Aitken, Benny Antony
- PMID
- 42515994
- DOI
- 10.1155/prm/3998239
Why clinicians should know about it
- Picked for Rheumatology (top studies of the week, 2 August 2026): Cannabis extracts show limited efficacy for osteoarthritis pain
Abstract
BACKGROUND: Interest in cannabis extracts for chronic pain, including osteoarthritis (OA), is growing. This systematic review evaluated the efficacy of cannabis extracts in OA across preclinical and clinical studies. METHODS: A comprehensive literature search was performed using Medline via Ovid, Embase via Ovid, CINAHL, and Cochrane Central Register of Controlled Trials database to identify studies published up to 2024. Studies assessing the efficacy and safety of cannabis extracts for OA in preclinical and clinical settings were included. Two researchers independently evaluated the risk of bias using the Cochrane Risk of Bias 2 tool and Office of Health Assessment and Translation (OHAT) risk of bias tool. RESULTS: Twenty-six studies (20 preclinical and 6 clinical) met the inclusion criteria. Most preclinical studies (n = 20) examined the effects of cannabis extracts in preclinical animal models of OA and domestic dogs with spontaneous OA, assessing structural changes (n = 8), proinflammatory modulation (n = 9), and pain (n = 13). Preliminary findings indicated that cannabis extracts exerted chondroprotective, chondrogenerative, anti-inflammatory, and analgesic effects in OA models, reducing hyperalgesia and mechanical/thermal allodynia. Six clinical studies investigated pain, quality of life (QoL), and function. Four randomized controlled trials (RCTs) found no significant benefits in pain relief, QoL, or functional improvement with cannabis extracts. Adverse effects were generally mild. CONCLUSION: Preclinical evidence provides preliminary, low-certainty support for the anti-inflammatory, analgesic, and chondroprotective properties of cannabinoid-based therapies in OA. Current clinical evidence remains insufficient to establish efficacy for pain or function. Further high-quality, large-scale RCTs are necessary to confirm the efficacy and clarify the safety profile of cannabis extracts in OA management.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.