• Rayyan Vaid, Areeba Fareed, Rabia Qader, Aariz Hussain, Wajiha Shaikh, Ushna Zameer, and Sidhant Ochani.
• Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan. rayyanvaid222@gmail.com.
• Ir J Med Sci. 2025 Jan 17.

ObjectiveThis meta-analysis aims to systematically evaluate the efficacy and safety of cannabis in the management of Crohn's disease (CD) by synthesizing evidence from randomized controlled trials (RCTs). By adhering to the 2020 PRISMA guidelines and registering the study protocol with PROSPERO, this research intends to offer robust, evidence-based recommendations for healthcare practitioners on the therapeutic potential and clinical implications of cannabis use in CD management.MethodsA literature search encompassing PubMed, Google Scholar, and the Cochrane Library was conducted to identify relevant RCTs comparing cannabis to placebo or standard therapy in CD patients. Inclusion criteria focused on outcomes such as remission rates, C-reactive protein (CRP) levels, quality of life (QoL), and adverse events (AEs). Statistical analysis using RevMan 5.3 involved weighted mean differences (MD) and 95% confidence intervals to compare outcomes between the cannabis and control groups.ResultsThe meta-analysis revealed significant findings regarding the impact of cannabis on CD management. The cannabis group exhibited significantly higher clinical remission rates at 8 weeks compared to the control group, with low heterogeneity [MD = - 67.98; 95% CI: (- 100.68, - 35.29)]. However, a statistically significant improvement in QoL was observed in the placebo group compared to the cannabis-treated group [MD = 19.62; 95% CI (14.24 to 25.00)]. There was a non-significant lowering in serum CRP levels compared to the placebo group [MD: - 0.51; 95% CI: (- 1.05, 0.02)].ConclusionThe study concludes that cannabis shows promise as a therapeutic option for CD, demonstrating higher remission rates and potential benefits for disease management. However, it also highlights the need for larger, standardized research studies to solidify conclusions regarding efficacy, safety, and biomarker responses in CD patients.© 2025. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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