ArticleFrontiers in pain research (Lausanne, Switzerland)2026
Cannabidiol/cannabigerol exposure and neuropathy-related outcomes after neurotoxic chemotherapy: a real-world cohort study.
Article in Frontiers in pain research (Lausanne, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication of neurotoxic chemotherapy, yet effective pharmacologic options for both prevention and treatment of established painful CIPN remain limited. Non-delta-9-tetrahydrocannabinol (THC) cannabinoids and related minor cannabinoids show antinociceptive effects in preclinical CIPN models, but their real-world clinical relevance remains unclear. Methods: We performed a retrospective secondary analysis of de-identified electronic health record (EHR) data using the TriNetX Research Network to examine whether documented cannabidiol/cannabigerol (CBD/CBG) exposure was associated with subsequent neuropathy-related diagnoses among adults receiving neurotoxic chemotherapy. Patients with neuropathy-related diagnoses on or before chemotherapy were excluded. Two Cox proportional hazards analyses were performed. The post-chemotherapy exposure analysis compared post-chemotherapy CBD/CBG exposure with post-chemotherapy exposure to gabapentin, pregabalin, or duloxetine. The pre-chemotherapy exposure analysis compared patients with documented CBD/CBG exposure within one year before chemotherapy to patients who had no documented CBD/CBG exposure during that pre-chemotherapy window. The outcome was a composite neuropathy-related diagnosis 30-365 days after the index event. Results: In the adjusted post-chemotherapy exposure model, 83 CBD/CBG-exposed patients were compared with 118,001 active-comparator patients. Post-chemotherapy CBD/CBG exposure was associated with lower hazard of subsequent neuropathy-related diagnosis-code outcomes (Hazard ratio [HR] = 0.162, 95% confidence interval [CI] = 0.041-0.649, Conclusions: Post-chemotherapy CBD/CBG exposure was associated with lower observed hazard of neuropathy-related diagnosis-code outcomes, whereas pre-chemotherapy exposure was not significant. These exploratory findings require cautious interpretation because of sparse exposed-arm events, EHR exposure limitations, and potential competing-risk bias.
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