Qualidade de vida em pacientes com Fibromialgia que utilizam medicamentos derivados de Cannabis: Uma revisão de escopo

Abstract

Fibromyalgia (FM) is a rheumatological disease characterized by diffuse chronic pain, fatigue, sleep disturbances, and cognitive symptoms. Treatment involves the use of different pharmacological classes, but the response varies among patients, making an individualized approach necessary. Given these limitations, the use of Cannabis sativa L. derivatives emerges as a promising alternative, especially for adjusting pain modulation, justifying the need to evaluate its impact on the quality of life of these patients. This study aims to map the evidence related to the assessment of quality of life (QoL) in patients with fibromyalgia after the use of Cannabis for medicinal purposes and to identify possible existing gaps in knowledge on this topic. Based on the Joanna Briggs Institute (JBI) manual and the international guideline Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), a search was conducted in the Scielo, PubMed, Embase, Cochrane, and LILACS (BVS) databases for observational studies (OS), systematic reviews (SR), meta-analyses, and randomized controlled trials (RCTs) that mentioned the use of cannabis-derived products in patients with fibromyalgia (FM). These studies should include a direct or indirect assessment of quality of life. The searches were conducted between November 2024 and January 2025. 292 articles were found, of which 23 articles produced between 2008 and 2024 were included. These studies were conducted in Europe (n=5), North America (n=2), South America (n=2), Asia (n=1), and Oceania (n=1). The number of participants ranged from 7 to 1923 patients, with a predominance of female participants and a mean age between 33.4 and 56.6 years. Quality of life (QoL) was a primary outcome in 10 studies. The main instruments used to assess quality of life were the FIQ, FIQR, EQ-5D-5L, and WHOQOL-BREF. The study highlighted a significant gap in the methodology of OBS and RCT research, the absence of quality of life assessment before and after interventions, and a short reassessment period. Although efficient instruments for assessing quality of life exist, there is still no systematic standardization of their use, especially in RCTs, a fact that may compromise the confirmation of the effectiveness of promising treatments, such as the use of cannabis for medicinal purposes in fibromyalgia.