Dronabinol for the reduction of chronic pain and inflammation in people with sickle cell disease

柯蒂斯博士寻求成为一名独立资助的镰状细胞疾病研究员 重点放在慢性疼痛的理解和治疗上。慢性疼痛是一个严重的问题 适用于患有镰状细胞病(SCD)的人。这种疼痛主要是用阿片类药物治疗的，但对于 许多SCD阿片类药物患者不足以单独治疗慢性疼痛。大麻素( 大麻中的主要活性物质)已被证明对慢性和 在非SCD疾病中，神经病理性疼痛和减轻炎症。SCD中的炎症不是 这只与疼痛有关，但也与终末器官损伤率高有关。超过一人 三分之一的SCD患者表示他们使用大麻来缓解疼痛，但目前没有证据表明 以支持这一用途。此外，没有证据表明这一做法的不利影响 可能适用于患有SCD的人。对于医生应该告诉病人什么，没有指导方针 他们问大麻产品是否能缓解他们的痛苦。 这项提议试图通过安慰剂控制的双面具8来弥补这一差距 FDA批准的含有四氢大麻酚的口服药物屈诺麻酚的为期一周的研究 (THC)，大麻的主要活性成分。本研究的目的有一：确定 屈诺比诺是否会改善患有SCD和慢性疼痛的成年人的疼痛和生活质量，2：至 评价屈诺比诺对慢性阻塞性肺疾病患者炎症标志物的影响 安慰剂，3：确定成人SCD患者使用屈诺比诺的安全性和耐受性 与安慰剂相比。如果发现屈奴比诺可以改善慢性疼痛或生活质量，或 减少炎症标志物，应该在更大的试验中进行研究。了解安全和 屈诺比诺的耐受性不仅将指导未来的研究，而且将有助于临床医生和患者 了解使用大麻可能存在的一些风险。 通过这个职业发展奖，柯蒂斯博士将获得临床试验方面的专业知识 设计和实施、纵向数据分析和高级建模技术，以及 慢性疼痛研究的临床和翻译方面。她的顾问委员会由 临床试验开发、SCD中的疼痛、SCD中的炎症和统计方面的专家。 通过与多学科指导团队合作，拟议的研究项目，以及 正式的课程，柯蒂斯博士将能够成为一名独立的临床调查员 镰状细胞病的慢性疼痛治疗方面的专业知识。

Dr. Curtis seeks to become an independently funded investigator in sickle cell disease with a focus on the understanding and treatment of chronic pain. Chronic pain is a critical issue for people with sickle cell disease (SCD). This pain is primarily treated with opioids, but for many people with SCD opioids are inadequate to treat chronic pain alone. Cannabinoids (the primary active agents in marijuana) have been shown to be effective for chronic and neuropathic pain and reduce inflammation in non-SCD diseases. Inflammation in SCD is not only correlated with pain but is also correlated with high rates of end organ damage. Over one third of people with SCD say they use cannabis for pain relief, but there is currently no evidence to support this use. Further, there is no evidence to suggest what the adverse effects of this use might be for people with SCD. There are no guidelines for what doctors should tell patients with SCD who ask if cannabis products might help their pain. This proposal seeks to address this gap with a placebo-controlled, double-masked, 8 week-long study of dronabinol, an FDA approval oral agent which contains tetrahydrocannabinol (THC), the primary active ingredient in cannabis. The aims of this study are 1: To determine whether dronabinol will improve pain and QOL in adults with SCD and chronic pain, 2: To assess dronabinol's effect on markers of inflammation in patients with SCD compared to placebo, And 3: To determine the safety and tolerability of dronabinol use in adults with SCD compared to placebo. If dronabinol is found to improve chronic pain, or quality of life, or to reduce markers of inflammation, it should studied in a larger trial. Understanding the safety and tolerability of dronabinol will guide not only future studies but will help clinicians and patients understand some of the possible risks of cannabis use. Through this career development award Dr. Curtis will gain expertise in clinical trial design and execution, longitudinal data analysis and advanced modelling techniques, and clinical and translational aspects of the study of chronic pain. Her advisory committee consists of experts in clinical trial development, pain in SCD, inflammation in SCD, and statistics. Through working with a multidisciplinary mentorship team, the proposed research project, and formal coursework, Dr. Curtis will be able to become an independent clinical investigator with expertise in chronic pain treatment in sickle cell disease.