Cannabis Use May Decrease Risk for Mortality and Poorer Clinical Outcomes Among Patients With Cirrhosis

A retrospective study found that cannabis use among patients with compensated and decompensated cirrhosis decreased risk for inpatient mortality and poor clinical outcomes. These findings were awarded the American College of Gastroenterology (ACG) Presidential Poster Award at the ACG 2021 Annual Meeting, held from October 22 to 27, 2021, in Las Vegas, Nevada and virtually.

Using cannabis as a medicinal product remains controversial; however, there has been certain evidence that the endocannabinoid system, via a mechanism of reducing portal pressure, may be a potential therapeutic target among patients with cirrhosis.

In order to better assess the therapeutic potential between the endocannabinoid system and cirrhosis, researchers from the Robert Wood Johnson Medical School at Rutgers University sourced data from the Nationwide Inpatient Sample, collected between October 2015 and December 2018. Patients (N=311,701) with cirrhosis were assessed by multivariate regression for clinical outcomes on the basis of cannabis use codes.

Patients had compensated (60%; n=187,042) and decompensated (40%; n=124,659) cirrhosis. Among the compensated and decompensated cohorts, 1.56% (n=2927) and 1.39% (n=1731) were cannabis users, respectively.

Cannabis use was associated with decreased risk for mortality among the compensated (adjusted odds ratio [aOR], 0.63; 95% CI, 0.50-0.80) and decompensated (aOR, 0.67; 95% CI, 0.54-0.83) cohorts.

Risk for new-onset dialysis was decreased among the compensated (aOR, 0.57; 95% CI, 0.45-0.70) and decompensated (aOR, 0.49; 95% CI, 0.38-0.65) cohorts. Among the decompensated group, cannabis use also decreased risk for admission to the intensive care unit (aOR, 0.76; 95% CI, 0.64-0.90).

This study may have underestimated the use of cannabis due to the reliance on medical coding information.

These data indicated that using cannabis may decrease risk for poor clinical outcomes ¾ such as mortality, new-onset dialysis, and admission to the intensive care unit ¾ among patients with compensated or decompensated cirrhosis. These data support the execution of future randomized controlled studies examining the endocannabinoid system in the setting of cirrhosis.

Reference

Zhao E, Kabaria S, Patel AV. Cannabis use decreases morbidity and mortality among cirrhosis patients: a national cohort study. Presented at: ACG 2021 Annual Meeting; October 22-27, 2021; Las Vegas, NV and virtual. Abstract P2837.