Pain Inflammation and Cannabis in HIV

NCT ID: NCT05554146

Last Updated: 2025-11-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-28

Study Completion Date

2024-05-03

Brief Summary

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This study will examine how medical cannabis use affects neuropathic pain, inflammation and adverse events in people living with HIV (PLWH) with neuropathic pain. The investigators will observe how varying ratios of tetrahydrocannabinol (THC) and cannabidiol (CBD) in medical cannabis impact neuropathic pain, inflammation and adverse events.

Detailed Description

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This study will examine how medical cannabis use affects neuropathic pain in PLWH with neuropathic pain. The investigators will enroll adults with HIV who have a) neuropathic pain, b) are actively certified for medical cannabis, and c) intend to have soft gel capsule products dispensed at Vireo (medical cannabis dispensary). The investigators will observe how pain and inflammation change in participants after they are randomized to receive high THC:low CBD product, an equal THC:CBD product, a low THC:high CBD product, or placebo by our collaborator in a separate study. Over 14 weeks, data sources will include questionnaires, blood samples, urine samples; medical, pharmacy, and Prescription Monitoring Program (PMP) records. The primary independent variable will be type of medical cannabis product dispensed at dispensary, and the primary outcome will be self-reported pain.

Conditions

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HIV Infections Neuropathic Pain Cannabis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

We will observe participants who are enrolled in one of 4 arms in a partnering study over 14 weeks.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Coupon for a Discounted Placebo Product

We will observe participants who were previously randomized to a coupon for discounted placebo soft-gel capsules by our collaborators, Vireo.

Group Type OTHER

Receipt of Coupon for Placebo Soft-Gel Capsule

Intervention Type OTHER

The investigators will follow participants who were randomized to receive a coupon for placebo soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Placebo (0:0) Softgel, 0mg THC and 0mg CBD per cap, Bottle of 30 caps

Coupon for a Discounted High THC Product

We will observe participants who were previously randomized to a coupon for discounted 4.29 mg THC/0.72 mg CBD soft-gel capsules by our collaborators, Vireo.

Group Type OTHER

Receipt of Coupon for High THC Soft-Gel Capsule

Intervention Type OTHER

The investigators will follow participants who were randomized to receive a coupon for high THC soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Vireo Yellow (6:1) Softgel, 4.29mg THC and 0.72mg CBD per cap, Bottle of 30 caps

Coupon for a Discounted Equal THC and CBD Product

We will observe participants who were previously randomized to a coupon for discounted 2.5 mg THC/2.5 mg CBD soft-gel capsules by our collaborators, Vireo.

Group Type OTHER

Receipt of Coupon for Equal THC and CBD Soft-Gel Capsule

Intervention Type OTHER

The investigators will follow participants who were randomized to receive a coupon for equal THC and CBD soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Vireo Green (1:1) Softgel, 2.5mg THC and 2.5mg CBD per cap, Bottle of 30 caps

Coupon for a Discounted High CBD Product

We will observe participants who were previously randomized to a coupon for discounted 0.25 mg THC/4.75 mg CBD soft-gel capsules by our collaborators, Vireo.

Group Type OTHER

Receipt of Coupon for High CBD Soft-Gel Capsule

Intervention Type OTHER

The investigators will follow participants who were randomized to receive a coupon for high CBD soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Vireo Indigo (1:19) Softgel, 0.25mg THC and 4.75mg CBD per cap, Bottle of 30 caps

Interventions

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Receipt of Coupon for Placebo Soft-Gel Capsule

The investigators will follow participants who were randomized to receive a coupon for placebo soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Placebo (0:0) Softgel, 0mg THC and 0mg CBD per cap, Bottle of 30 caps

Intervention Type OTHER

Receipt of Coupon for High THC Soft-Gel Capsule

The investigators will follow participants who were randomized to receive a coupon for high THC soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Vireo Yellow (6:1) Softgel, 4.29mg THC and 0.72mg CBD per cap, Bottle of 30 caps

Intervention Type OTHER

Receipt of Coupon for Equal THC and CBD Soft-Gel Capsule

The investigators will follow participants who were randomized to receive a coupon for equal THC and CBD soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Vireo Green (1:1) Softgel, 2.5mg THC and 2.5mg CBD per cap, Bottle of 30 caps

Intervention Type OTHER

Receipt of Coupon for High CBD Soft-Gel Capsule

The investigators will follow participants who were randomized to receive a coupon for high CBD soft-gel capsule medical cannabis products by our collaborators at Vireo medical cannabis dispensary in a separate study

Vireo Indigo (1:19) Softgel, 0.25mg THC and 4.75mg CBD per cap, Bottle of 30 caps

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

-\>=18 years old

* Diagnosis of HIV
* Fluency in English
* Active certification for medical cannabis
* ICD-10 diagnosis code for neuropathic pain, OR Neuropathic pain in problem list of electronic medical record, OR Neuropathic pain per medical cannabis certification form, OR Neuropathic Pain Questionnaire-Short Form\>0

Exclusion Criteria

* Inability to provide informed consent
* Inability to complete 14 weeks of study visits
* Medical cannabis use within 14 days of enrollment, and no medical cannabis dispensed within 30 days of enrollment
* Unique pain symptoms (e.g., multiple sclerosis, rheumatoid arthritis)
* Terminal illness
* Current or prior psychotic disorder
* Unregulated cannabis use in the past 14 days; opioid or cocaine use in the past 30 days
* Dispensed opioids within 30 days
* Non-steroidal anti-inflammatory use within 7 days prior to enrollment
* Steroid use within the past 14 days with duration of therapy \>=21 days
* COVID vaccination or booster within 14 days of screening
* Active or acute cardiac disease based on clinician chart review.
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

University of Colorado, Boulder

OTHER

Sponsor Role collaborator

University of Pittsburgh

OTHER

Sponsor Role collaborator

Vireo Health

OTHER

Sponsor Role collaborator

Montefiore Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Deepika E Slawek, MD, MPH, MS

Role: PRINCIPAL_INVESTIGATOR

Montefiore Medical Center

Locations

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Montefiore Health System

The Bronx, New York, United States

Site Status

Countries

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United States

References

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Newshan G, Bennett J, Holman S. Pain and other symptoms in ambulatory HIV patients in the age of highly active antiretroviral therapy. J Assoc Nurses AIDS Care. 2002 Jul-Aug;13(4):78-83. doi: 10.1016/S1055-3290(06)60373-7.

Reference Type BACKGROUND
PMID: 12149887 (View on PubMed)

National Conference of State Legislatures. State Medical Marijuana Laws. Published 2020. Updated 11/6/2020.

Reference Type BACKGROUND

New York State Department of Health. Medical Use of Marijuana Under the Compassionate Care Act. In. Vol 22018.

Reference Type BACKGROUND

Russo E, Guy GW. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Med Hypotheses. 2006;66(2):234-46. doi: 10.1016/j.mehy.2005.08.026. Epub 2005 Oct 4.

Reference Type BACKGROUND
PMID: 16209908 (View on PubMed)

Merlin JS, Cen L, Praestgaard A, Turner M, Obando A, Alpert C, Woolston S, Casarett D, Kostman J, Gross R, Frank I. Pain and physical and psychological symptoms in ambulatory HIV patients in the current treatment era. J Pain Symptom Manage. 2012 Mar;43(3):638-45. doi: 10.1016/j.jpainsymman.2011.04.019. Epub 2011 Nov 23.

Reference Type BACKGROUND
PMID: 22115794 (View on PubMed)

Harding R, Lampe FC, Norwood S, Date HL, Clucas C, Fisher M, Johnson M, Edwards S, Anderson J, Sherr L. Symptoms are highly prevalent among HIV outpatients and associated with poor adherence and unprotected sexual intercourse. Sex Transm Infect. 2010 Dec;86(7):520-4. doi: 10.1136/sti.2009.038505. Epub 2010 Jun 15.

Reference Type BACKGROUND
PMID: 20551235 (View on PubMed)

Silverberg MJ, Jacobson LP, French AL, Witt MD, Gange SJ. Age and racial/ethnic differences in the prevalence of reported symptoms in human immunodeficiency virus-infected persons on antiretroviral therapy. J Pain Symptom Manage. 2009 Aug;38(2):197-207. doi: 10.1016/j.jpainsymman.2008.08.007. Epub 2009 Mar 28.

Reference Type BACKGROUND
PMID: 19329274 (View on PubMed)

Cervia LD, McGowan JP, Weseley AJ. Clinical and demographic variables related to pain in HIV-infected individuals treated with effective, combination antiretroviral therapy (cART). Pain Med. 2010 Apr;11(4):498-503. doi: 10.1111/j.1526-4637.2010.00802.x. Epub 2010 Mar 4.

Reference Type BACKGROUND
PMID: 20210870 (View on PubMed)

Lee KA, Gay C, Portillo CJ, Coggins T, Davis H, Pullinger CR, Aouizerat BE. Symptom experience in HIV-infected adults: a function of demographic and clinical characteristics. J Pain Symptom Manage. 2009 Dec;38(6):882-93. doi: 10.1016/j.jpainsymman.2009.05.013.

Reference Type BACKGROUND
PMID: 19811886 (View on PubMed)

Merlin JS, Westfall AO, Raper JL, Zinski A, Norton WE, Willig JH, Gross R, Ritchie CS, Saag MS, Mugavero MJ. Pain, mood, and substance abuse in HIV: implications for clinic visit utilization, antiretroviral therapy adherence, and virologic failure. J Acquir Immune Defic Syndr. 2012 Oct 1;61(2):164-70. doi: 10.1097/QAI.0b013e3182662215. Erratum In: J Acquir Immune Defic Syndr. 2013 May 1;63(1):e38-9.

Reference Type BACKGROUND
PMID: 22766967 (View on PubMed)

Miaskowski C, Penko JM, Guzman D, Mattson JE, Bangsberg DR, Kushel MB. Occurrence and characteristics of chronic pain in a community-based cohort of indigent adults living with HIV infection. J Pain. 2011 Sep;12(9):1004-16. doi: 10.1016/j.jpain.2011.04.002.

Reference Type BACKGROUND
PMID: 21684218 (View on PubMed)

Bruce RD, Merlin J, Lum PJ, Ahmed E, Alexander C, Corbett AH, Foley K, Leonard K, Treisman GJ, Selwyn P. 2017 HIV Medicine Association of Infectious Diseases Society of America Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With Human Immunodeficiency Virus. Clin Infect Dis. 2017 Oct 30;65(10):1601-1606. doi: 10.1093/cid/cix848.

Reference Type BACKGROUND
PMID: 29091230 (View on PubMed)

Phillips TJC, Brown M, Ramirez JD, Perkins J, Woldeamanuel YW, Williams ACC, Orengo C, Bennett DLH, Bodi I, Cox S, Maier C, Krumova EK, Rice ASC. Sensory, psychological, and metabolic dysfunction in HIV-associated peripheral neuropathy: A cross-sectional deep profiling study. Pain. 2014 Sep;155(9):1846-1860. doi: 10.1016/j.pain.2014.06.014. Epub 2014 Jun 26.

Reference Type BACKGROUND
PMID: 24973717 (View on PubMed)

Merlin JS. Chronic Pain in Patients With HIV Infection: What Clinicians Need To Know. Top Antivir Med. 2015 Aug-Sep;23(3):120-4.

Reference Type BACKGROUND
PMID: 26518396 (View on PubMed)

Van der Watt JJ, Wilkinson KA, Wilkinson RJ, Heckmann JM. Plasma cytokine profiles in HIV-1 infected patients developing neuropathic symptoms shortly after commencing antiretroviral therapy: a case-control study. BMC Infect Dis. 2014 Feb 10;14:71. doi: 10.1186/1471-2334-14-71.

Reference Type BACKGROUND
PMID: 24512313 (View on PubMed)

Manchikanti L, Cash KA, Damron KS, Manchukonda R, Pampati V, McManus CD. Controlled substance abuse and illicit drug use in chronic pain patients: An evaluation of multiple variables. Pain Physician. 2006 Jul;9(3):215-25.

Reference Type BACKGROUND
PMID: 16886030 (View on PubMed)

Merlin JS, Zinski A, Norton WE, Ritchie CS, Saag MS, Mugavero MJ, Treisman G, Hooten WM. A conceptual framework for understanding chronic pain in patients with HIV. Pain Pract. 2014 Mar;14(3):207-16. doi: 10.1111/papr.12052. Epub 2013 Apr 1.

Reference Type BACKGROUND
PMID: 23551857 (View on PubMed)

Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003 Nov 10;163(20):2433-45. doi: 10.1001/archinte.163.20.2433.

Reference Type BACKGROUND
PMID: 14609780 (View on PubMed)

Fishbain DA. Approaches to treatment decisions for psychiatric comorbidity in the management of the chronic pain patient. Med Clin North Am. 1999 May;83(3):737-60, vii. doi: 10.1016/s0025-7125(05)70132-2.

Reference Type BACKGROUND
PMID: 10386123 (View on PubMed)

Morasco BJ, Gritzner S, Lewis L, Oldham R, Turk DC, Dobscha SK. Systematic review of prevalence, correlates, and treatment outcomes for chronic non-cancer pain in patients with comorbid substance use disorder. Pain. 2011 Mar;152(3):488-497. doi: 10.1016/j.pain.2010.10.009. Epub 2010 Dec 23.

Reference Type BACKGROUND
PMID: 21185119 (View on PubMed)

Rivera-Rivera Y, Garcia Y, Toro V, Cappas N, Lopez P, Yamamura Y, Rivera-Amill V. Depression Correlates with Increased Plasma Levels of Inflammatory Cytokines and a Dysregulated Oxidant/Antioxidant Balance in HIV-1-Infected Subjects Undergoing Antiretroviral Therapy. J Clin Cell Immunol. 2014 Dec;5(6):1000276. doi: 10.4172/2155-9899.1000276.

Reference Type BACKGROUND
PMID: 25674354 (View on PubMed)

Surratt HL, Kurtz SP, Levi-Minzi MA, Cicero TJ, Tsuyuki K, O'Grady CL. Pain treatment and antiretroviral medication adherence among vulnerable HIV-positive patients. AIDS Patient Care STDS. 2015 Apr;29(4):186-92. doi: 10.1089/apc.2014.0104. Epub 2014 Jul 1.

Reference Type BACKGROUND
PMID: 24984142 (View on PubMed)

Merlin JS, Long D, Becker WC, Cachay ER, Christopoulos KA, Claborn K, Crane HM, Edelman EJ, Harding R, Kertesz SG, Liebschutz JM, Mathews WC, Mugavero MJ, Napravnik S, C O'Cleirigh C, Saag MS, Starrels JL, Gross R. Brief Report: The Association of Chronic Pain and Long-Term Opioid Therapy With HIV Treatment Outcomes. J Acquir Immune Defic Syndr. 2018 Sep 1;79(1):77-82. doi: 10.1097/QAI.0000000000001741.

Reference Type BACKGROUND
PMID: 29771793 (View on PubMed)

Abrams DI, Jay CA, Shade SB, Vizoso H, Reda H, Press S, Kelly ME, Rowbotham MC, Petersen KL. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology. 2007 Feb 13;68(7):515-21. doi: 10.1212/01.wnl.0000253187.66183.9c.

Reference Type BACKGROUND
PMID: 17296917 (View on PubMed)

Ellis RJ, Toperoff W, Vaida F, van den Brande G, Gonzales J, Gouaux B, Bentley H, Atkinson JH. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology. 2009 Feb;34(3):672-80. doi: 10.1038/npp.2008.120. Epub 2008 Aug 6.

Reference Type BACKGROUND
PMID: 18688212 (View on PubMed)

Vergara D, Bidwell LC, Gaudino R, Torres A, Du G, Ruthenburg TC, deCesare K, Land DP, Hutchison KE, Kane NC. Compromised External Validity: Federally Produced Cannabis Does Not Reflect Legal Markets. Sci Rep. 2017 Apr 19;7:46528. doi: 10.1038/srep46528.

Reference Type BACKGROUND
PMID: 28422145 (View on PubMed)

Volkow ND, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014 Aug 28;371(9):879. doi: 10.1056/NEJMc1407928. No abstract available.

Reference Type BACKGROUND
PMID: 25162899 (View on PubMed)

Patton GC, Coffey C, Carlin JB, Degenhardt L, Lynskey M, Hall W. Cannabis use and mental health in young people: cohort study. BMJ. 2002 Nov 23;325(7374):1195-8. doi: 10.1136/bmj.325.7374.1195.

Reference Type BACKGROUND
PMID: 12446533 (View on PubMed)

Caspi A, Moffitt TE, Cannon M, McClay J, Murray R, Harrington H, Taylor A, Arseneault L, Williams B, Braithwaite A, Poulton R, Craig IW. Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction. Biol Psychiatry. 2005 May 15;57(10):1117-27. doi: 10.1016/j.biopsych.2005.01.026.

Reference Type BACKGROUND
PMID: 15866551 (View on PubMed)

Bonn-Miller MO, Oser ML, Bucossi MM, Trafton JA. Cannabis use and HIV antiretroviral therapy adherence and HIV-related symptoms. J Behav Med. 2014 Feb;37(1):1-10. doi: 10.1007/s10865-012-9458-5. Epub 2012 Oct 7.

Reference Type BACKGROUND
PMID: 23054178 (View on PubMed)

Slawson G, Milloy MJ, Balneaves L, Simo A, Guillemi S, Hogg R, Montaner J, Wood E, Kerr T. High-intensity cannabis use and adherence to antiretroviral therapy among people who use illicit drugs in a Canadian setting. AIDS Behav. 2015 Jan;19(1):120-7. doi: 10.1007/s10461-014-0847-3.

Reference Type BACKGROUND
PMID: 25012624 (View on PubMed)

Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004 Sep-Oct;20(5):309-18. doi: 10.1097/00002508-200409000-00005.

Reference Type BACKGROUND
PMID: 15322437 (View on PubMed)

Moriarty AS, Gilbody S, McMillan D, Manea L. Screening and case finding for major depressive disorder using the Patient Health Questionnaire (PHQ-9): a meta-analysis. Gen Hosp Psychiatry. 2015 Nov-Dec;37(6):567-76. doi: 10.1016/j.genhosppsych.2015.06.012. Epub 2015 Jun 18.

Reference Type BACKGROUND
PMID: 26195347 (View on PubMed)

Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.

Reference Type BACKGROUND
PMID: 16717171 (View on PubMed)

McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, Pettinati H, Argeriou M. The Fifth Edition of the Addiction Severity Index. J Subst Abuse Treat. 1992;9(3):199-213. doi: 10.1016/0740-5472(92)90062-s.

Reference Type BACKGROUND
PMID: 1334156 (View on PubMed)

Greene B, Bernardo L, Thompson M, Loughead J, Ashare R. Behavioral Economic Strategies to Improve Enrollment Rates in Clinical Research: Embedded Recruitment Pilot Trial. JMIR Form Res. 2023 Jul 21;7:e47121. doi: 10.2196/47121.

Reference Type BACKGROUND
PMID: 37477975 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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K23DA053997

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2021-13662

Identifier Type: -

Identifier Source: org_study_id