A Descriptive Analysis of Adverse Event Reports from the Quebec Cannabis Registry

Yasmina Hachem, Yola Moride (), Anne-Marie Castilloux, Genaro Castillon, Maja Kalaba, Andrée Néron, Rihab Gamaoun, Marc O. Martel, Pierre Beaulieu, Mark Ware and Antonio Vigano
Additional contact information
Yasmina Hachem: McGill University Health Center
Yola Moride: Rutgers, The State University of New Jersey
Anne-Marie Castilloux: YolaRX Consultants
Genaro Castillon: YolaRX Consultants
Maja Kalaba: Canopy Growth Corporation
Andrée Néron: Bureau d’évaluation médicale (Consultant on request in medical cannabis-related pharmacological assessments and needs for injured workers)
Rihab Gamaoun: Research Institute of the McGill University Health Centre
Marc O. Martel: McGill University
Pierre Beaulieu: Faculté de médecine de l’Université de Montréal
Mark Ware: McGill University Health Center
Antonio Vigano: McGill University Health Center

Drug Safety, 2024, vol. 47, issue 2, No 6, 171 pages

Abstract: Abstract Introduction Published data on the safety of natural medical cannabis (MC) when used in the real-world clinical practice setting are lacking. This study aimed to describe adverse events (AEs) reported across three years following MC initiation. Methods The Quebec Cannabis Registry (QCR) was a prospective registry of adults enrolled through participating physicians when they initiated MC between May 2015 and October 2018. Follow-up ended at MC discontinuation, loss to follow-up, three years, or end of data collection (May 2019). Data were collected at baseline and at follow-up visits every three months for the first two years, then once in the third year. Physicians filled adverse event (AE) reports, which were coded using MedDRA® preferred terms (PTs), and descriptive analyses were conducted. Results A total of 2991 patients were enrolled (mean age 50.9 years, 50.2% females). During follow-up, 108 patients (3.6%) experienced moderate or severe AEs, yielding 111 AE reports (three patients had two reports) and 214 AEs (average 1.9 AEs per report). Mild AEs were recorded as a reason for MC discontinuation for nine patients, but no AE reports were available. The most common PTs for ingested MC (62 reports) were dizziness (12.9%), nausea (11.3%), somnolence (9.7%), and vomiting (8.1%), and for inhaled MC (23 reports), headache (13.0%) was the most common. The most frequent PTs associated with tetrahydrocannabinol (THC)-dominant MC (25 reports) were dizziness and somnolence (12.0% each); for cannabidiol (CBD)-dominant MC (20 reports), vomiting (20.0%) was most common; and dizziness (17.2%), nausea (13.8%), somnolence (10.3%), and headache (8.6%) were the most frequent for balanced MC (58 reports). Conclusion No new safety concerns were identified relative to the published literature, although notable differences in AE profile between modes of administration and cannabinoid content ratios should be considered by health professionals. Further work identifying and managing risk factors for AEs is warranted to maintain a favorable benefit-risk balance for MC.

Date: 2024
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DOI: 10.1007/s40264-023-01379-0

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