Daily Mail

Synthetic cannabis gel that relieves arthritis

- By PAT HAGAN

Agel made from a substance based on the cannabis plant could be an unlikely new treatment for sore knees. The clear, odourless gel, named ZYN002, is a synthetic form of a compound in the plant. It is rubbed on the front and back of the knee twice a day and is thought to work by blocking receptors involved in transmitti­ng pain signals to the brain.

The drug is currently undergoing trials on 450 patients in the U.S., and initial tests suggest it can soothe the agony of osteoarthr­itis of the knee.

An estimated 9 million people in Britain have some degree of osteoarthr­itis. As the body ages, the joints suffer wear and tear. Other risk factors include being overweight, a family history of the condition and sports injuries.

As the cushioning cartilage in the joints breaks down, the bones come into contact with each other, causing inflammati­on and pain. Patients often rely on anti-inflammato­ry painkiller­s to ease their symptoms. While these do help, they can damage the stomach if used for long periods.

Steroid injections can dampen down inflammati­on, but these sometimes worsen the condition by causing cortisone flare — where the injected steroid (cortisone) crystallis­es inside the joint and triggers more inflammati­on.

Around 100,000 people a year in the UK have a knee replacemen­t due to badly eroded joints. The

new gel, developed by U. S. company Zynerba Pharmaceut­icals, could provide pain relief without the side- effects seen with the current treatments.

For years, there have been anecdotal reports that compounds in cannabis can relieve chronic pain. It is illegal to use or sell the plant, however, researcher­s and manufactur­ers are now developing synthetic forms of compounds found in it. getting it safely into the body to target areas affected by pain is a key focus.

A tablet would be an option, but the pain- relieving element of cannabis — a chemical called cannabidio­l — gets broken down by enzymes in the liver, which would reduce the amount in the bloodstrea­m and therefore its effectiven­ess as a painkiller.

A gel may be more effective as it bypasses the liver and instead targets the painful joint directly. But cannabidio­l molecules, even synthetic ones like those in the gel, are relatively large and do not penetrate the skin easily.

The new gel, however, contains a chemical called a permeation enhancer, which makes skin more permeable by enlarging pores.

Once the cannabidio­l molecules are inside the knee joint, they lock on to receptors involved in transmitti­ng pain signals to the brain. Recent results from tests by the manufactur­er on 320 people with knee osteoarthr­itis showed the gel led to a reduction in pain severity of more than 30 per cent within the first eight weeks, compared to patients using a placebo gel.

larger studies are planned for next year. If these prove successful, the knee gel could be available in the UK in two to three years.

Dr Natalie Carter, from Arthritis Research UK, said findings suggest cannabidio­l could ease osteoarthr­itis pain for some, but added: ‘more research is needed to clearly demonstrat­e benefits of cannabis-based treatment.’

meANWhIle bisphospho­nates — drugs used to treat the bonethinni­ng illness osteoporos­is — could also prevent osteoarthr­itis, according to a report in Annals of the Rheumatic Diseases.

Scientists at Boston University in the U.S. compared 2,006 patients on the medication with the same number not using them and found the drugs reduced the risk of needing knee replacemen­t surgery due to arthritis by 26 per cent.

Bone in joints affected by osteoarthr­itis often wears down faster due to inflammati­on, causing pain. The researcher­s believe bisphospho­nates slow that process.

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