New research suggests that dronabinol, a cannabinoid receptor activator, could serve as a novel approach to treating non-cardiac chest pain due to esophageal hypersensitivity.
Not all chest pain comes from the heart. Each year, an estimated 200,000 Americans experience non-cardiac chest pain, which in addition to pain can involve painful swallowing, discomfort and anxiety. Since non-cardiac chest pain can cause painful symptoms that mimic a heart attack, patients often get scared and go to the emergency room. However, non-cardiac chest pain often originates in the esophagus.
Currently, treatment for non-cardiac chest pain includes pain modulators, such as selective serotonin reuptake inhibitors (SSRI), which only has a partial 40 to 50 percent response rate in alleviating symptoms.
New research, authored by Ron Schey, MD, FACG, gastroenterologist at the Temple University Hospital, suggests that treatment with dronabinol, which traditionally has been used to treat nausea and vomiting in HIV patients and cancer patients undergoing chemotherapy, may offer a new approach to treating non-cardiac chest pain.
Dr. Schey and his research team conducted a pilot study involving 13 patients with non-cardiac chest pain. They found that those who were given 5 mg of dronabinol twice-daily for four weeks fared better than patients who took a placebo. Those receiving dronabinol experienced improved pain tolerance and decreased frequency and intensity of chest pain. Additionally, no significant adverse effects were reported.
“This novel study has promising findings in future treatment for these patients,” said Dr. Schey, Associate Professor of Medicine at Temple University School of Medicine, who conducted the research while on staff at the University of Iowa Hospitals and Clinic, and analyzed data at the Temple along with Zubair Malik, MD, a first-year fellow in Temple’s Division of Gastroenterology.
According to Dr. Schey, despite encouraging results, the pilot study was very small and not designed to test dronabinol against current therapies available for non-cardiac chest pain, therefore it is difficult to calculate how the drug performs in comparison to existing treatments. Dr. Schey said that a larger scale study on the effects of dronabinol on non-cardiac chest pain will begin soon at Temple.
The abstract was presented on Monday in Philadelphia at the Annual Scientific Meeting of the American College of Gastroenterology.
Source: Temple Health.