CANNABIS SATIVA AS A THERAPEUTIC ALTERNATIVE IN THE MANAGEMENT OF PAIN AND INFLAMMATION IN AUTOIMMUNE DISEASES: A NARRATIVE REVIEW WITH AN EMPHASIS ON RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

Autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), are characterized by alterations in the immune response and inflammatory processes that can affect various tissues and organs, causing pain and functional limitations. In this context, Cannabis sativa derivatives, particularly cannabidiol (CBD), have attracted scientific interest because of their potential role in modulating inflammatory and immune mechanisms. This study aimed to analyze the scientific evidence on the therapeutic potential of Cannabis sativa for managing pain and inflammation in RA and SLE, considering its pharmacological mechanisms, experimental findings, and available clinical evidence. This qualitative, exploratory, and descriptive narrative literature review was conducted using the PubMed, SciELO, and Virtual Health Library (VHL) databases, covering publications from 2007 to October 10, 2026. Priority was given to original studies related to the diseases under investigation, including cellular and animal models, clinical research, and complementary studies on immune mechanisms and analgesia. The findings demonstrated effects on inflammatory mediators and immune parameters in certain experimental models, although heterogeneous responses, methodological limitations, and findings warranting attention to safety were also observed. In RA, preclinical findings suggest potential for investigating mechanisms associated with joint inflammation, but clinical evidence remains limited. In SLE, the evidence consists predominantly of mechanistic findings and associations between cannabinoid receptor expression and disease activity, with no direct demonstration of CBD's therapeutic efficacy. In conclusion, Cannabis sativa derivatives exhibit pharmacological potential that warrants further investigation; however, the available evidence is insufficient to establish their efficacy and safety in the treatment of RA and SLE.