Are Cannabis and Cannabinoids a Valid Treatment Option in Patients with Rheumatic Diseases? A narrative review

To evaluate current evidence regarding the efficacy and safety of cannabis and cannabinoids in patients with rheumatic diseases.

A narrative review was conducted based on a search for studies published between 2000 and 2026 evaluating cannabinoid therapies in rheumatic diseases.

We identified 17 preclinical studies on the mechanisms of action of cannabis and 43 clinical studies published between 2000 and 2026, including randomized trials, observational studies and systematic reviews. We identified two articles on rheumatoid arthritis, 10 on osteoarthritis (2 reviews and 8 clinical studies), 28 on fibromyalgia (9 reviews, 7 randomized control trials, 12 clinical studies), one on psoriatic arthritis, and one on systemic sclerosis. The evidence of an effect of cannabinoids was strongest for fibromyalgia and limited for rheumatoid arthritis and osteoarthritis. Most studies reported improvements in pain and sleep quality. Globally, cannabinoids were well tolerated.

Some studies suggest short-term symptomatic benefits of cannabinoid-based therapies, particularly in fibromyalgia, but the findings are inconsistent and limited by small samples, heterogeneous formulations, and risk of bias. Current evidence is insufficient to support routine clinical use or recommendations in rheumatic diseases.