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Law October 16, , PM EDT — The number of cannabis patents and applications has ramped up as companies look to secure their place in the rapidly growing industry, staking a claim on everything from vapes to cultivation techniques. But alongside the enthusiasm, there are lingering questions about how these patents will hold up over time. In and , the U. Patent and Trademark Office issued almost cannabis patents, according to data analytics firm Magic Number. That was more than in the previous seven years combined. Last year also brought the first time a company attempted to enforce a cannabis patent in federal court. There is a similar increase in the number of patent applications being filed. This was on par with filing activity for the entire period from to The surge in patent filings comes amid optimistic projections for the cannabis industry, which has seen rapid growth as more states legalize marijuana. There has been a steady stream of filings from drug companies and research entities for patents covering medical treatments and pharmaceutical compositions. Others have sought patents on cannabis-infused products, including toothpastes, coffee beans and alcoholic drinks. There are a couple of dominant filers: GW Pharmaceuticals has more than patents and applications, and vaping company Lunatech has over But patent activity has been largely characterized by low-volume filings from individual inventors and small to midsize companies. This exceeded the amount of investment in all of and more than doubled that of , the report said. Meanwhile, cannabis companies have been on a merger spree; the number of deals doubled from to As the industry continues to consolidate, attorneys said intellectual property will be a valuable asset for smaller companies in line for a potential takeover. A prime example is Canopy Growth Corp. Vancouver-based Nextleaf Solutions has placed an emphasis on intellectual property, amassing a global portfolio that includes more than 30 issued and pending patents related to cannabis extraction technology. Nextleaf has said it is the first publicly traded company to be issued a U. Yet even with the recent upswing in patent activity, attorneys say there is still room for innovation. With respect to medical uses, specifically, David Kramer, an attorney in the hemp and cannabinoids practice groups at Vicente Sederberg LLP, said there remains a research gap between the U. Federal legalization of marijuana in the U. The amount of academic articles and other published information in the field remains relatively small. That means USPTO examiners, who may be relatively unfamiliar with cannabis applications, also have a smaller pool of prior art to refer to when deciding whether to award a patent. Brett Schuman, co-chair of the cannabis practice at Goodwin Procter LLP, said cannabis patents can fall into a couple of broad buckets. Pharmaceutical companies, with their large research budgets and experienced IP departments, likely have some high quality, pharmaceutical-grade patents. Emerging cannabis companies fall into a second bucket. And that is where there can be some unevenness. The lack of prior art could make it difficult to challenge cannabis patents in the inter partes review at the Patent Trial and Appeal Board. IPR petitioners are able to argue a patent is obvious or anticipated based only on earlier patents and printed publications. There have also been questions about the viability of enforcing cannabis patents in federal court. United Cannabis Corp. Supreme Court decisions that natural phenomena cannot be patented, allowing the lawsuit to proceed. Perhaps there are some signals outside the patent context. Schuman noted there has been litigation involving other aspects of the cannabis industry, including contract cases. Federal courts have generally treated these cases like any other. Schuman and others expressed doubt that questions about whether the patents can be enforced have chilled the filing of infringement lawsuits. One reason is simply the nature of the products. News In the News. By Matthew Bultman Law October 16, , PM EDT — The number of cannabis patents and applications has ramped up as companies look to secure their place in the rapidly growing industry, staking a claim on everything from vapes to cultivation techniques. Download PDF. Related Professionals. Stay in the Know Receive insights from the most respected practitioners of IP law, straight to your inbox. Subscribe for Updates. Get insights from the most respected practitioners of IP law Subscribe.

Acute pancreatitis as a rare adverse event among cannabis users: A systematic review

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Official websites use. Share sensitive information only on official, secure websites. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4. The work cannot be used commercially without permission from the journal. Cannabis use has been steadily rising in the United States and can have multiple adverse effects, including cannabis-induced acute pancreatitis. This study aims to collate and highlight the significant demographics, clinical presentation, and outcomes in patients with cannabis-induced acute pancreatitis. A systematic literature search of electronic databases for peer-reviewed articles was conducted. After an initial search, we found articles through different electronic databases. After manually removing duplicates and articles that did not meet the criteria, 25 articles were included in our review. The mean age of all participants was Ultrasound was normal in the majority of patients, with findings of mild pancreatitis. Dilatation of intrahepatic or extrahepatic biliary ducts was not seen in any patients. The overall prognosis was good, with reported full recovery. Cannabis should be included in the differential diagnosis for the etiology of acute pancreatitis, which would help in early intervention and treatment for the mitigation of the rapidly progressive disease. Our study shows male predominance with a ratio among patients diagnosed with acute pancreatitis post cannabis use. Cannabis is the most widely used illicit drug globally. Weed can be described as a hallucinogen, depressant, or stimulant due to varying effects from person to person. It is now being used legally as a recreational drug and for medical purposes by more than half of the United States. About million people, 2. Severe adverse effects related to cannabis use are depression, disorientation, anxiety, seizures, schizophrenia, other psychosis, gastrointestinal diseases, and cardiovascular diseases. It has also been linked to the increased incidence of motor vehicle accidents. A rare presentation of cannabis-induced acute pancreatitis has come to light in the last couple of years. There is only limited literature available in case reports and case series. With this systematic review, we highlight the critical key clinical findings, duration, outcomes, and demographic details of cannabis-induced pancreatitis. This systematic review was conducted and reported in conformity with the Cochrane and Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. All the studies were carefully screened and exported to the Endnote library X9. A manual check was carried out to remove duplicates. Two reviewers D. Discrepancies regarding inclusion of studies were arbitrated by senior author V. We included studies with a history of cannabis use with the diagnosis of acute pancreatitis. The studies were carefully screened and exported to the EndNote references library software Clarivate , and all the duplicates were removed. A manual check was carried through to crosscheck for any remaining duplicates. A total of articles were extracted in the initial screening. Two reviewers V. The senior author arbitrated discrepancies regarding the inclusion of studies. The following data were extracted from the studies: demographic data study design, country, gender, and age , comorbidity, risk factors, symptoms, laboratory data, and imaging data. Three authors assembled all available information in a shared spreadsheet N. If any required data were missing, written in an incorrect format, or not reported in the article, the corresponding authors of the respective articles were contacted via email for clarification. Supplementary material related to the main article was also investigated in such cases. Finally, descriptive statistics was used to summarize the data in this article. The median and interquartile ranges were adopted to describe continuous variables, whereas frequencies and percentages were used for dichotomous data. All statistical analyses were conducted using the software R version 4. A preliminary database search using the keywords yielded articles, of which studies were duplicates. One hundred ninety-eight studies were further excluded after the initial title and abstract screening. A full-text review was conducted for the remaining 70 articles. Forty-five studies were further excluded based on exclusion criteria. A total of 25 studies that met the eligibility criteria were included in our systematic analysis Fig. Among the 25 studies, 22 studies were case reports, whereas 3 were case series in design. Summary table highlighting the baseline, demographic, and clinical outcomes among all included studies. Among all reported cases of acute pancreatitis, 16 cases have shown comorbidity findings, which include diabetes mellitus 2 of 16 Cannabis use, smoking, and alcohol consumption were the 3 most common risk factors reported, leading to acute pancreatitis. Data on symptoms were variably reported in 18 studies, thus making the total number of patients with a particular symptom different for each. Laboratory data of patients were obtained from 24 studies. Ultrasound findings were obtained from 16 out of 25 studies, that is, 19 patients. Ultrasound in 2 of 19 patients revealed mild pancreatitis, 2 of 19 patients had pancreatic enlargement and edema, and in 3 of 19 patients, the pancreas could not be visualized due to overlying bowel gas. Computed tomography CT findings were reported in 17 of 25 studies with 20 patients. Pancreatic edema and inflammation were seen in 7 of 20 patients, localized in the head in 1 patient. Peripancreatic fat inflammation and stranding were seen in 3 of 20 patients; 2 of 20 scans revealed necrotizing pancreatitis, 1 of which was distal, and the other involved both pancreas and liver. The hepatopancreatic necrosis was associated with intraperitoneal effusion. Complex fluid collections associated with inflamed pancreas were seen in 2 of 20 patients. Magnetic resonance imaging MRI findings were obtained from 9 of 25 studies, that is, 9 patients. In 1 patient, MRI revealed pancreatic necrosis with acute complex fluid collection and absence of biliary dilatation. Mild stranding of peripancreatic fat was seen in 1 patient. Magnetic resonance cholangiopancreatography revealed a pseudocyst 15 cm in diameter in 1 patient. Necrotizing pancreatitis and complex fluid collection were visualized in 3 of 20 patients. All patients recovered with conservative management with no associated mortality and also the patients were in constant follow up. Ceasing of cannabis use is the key treatment in the mentioned cases. Cannabis was first reported as a potential cause of acute pancreatitis in by Grant and Gandhi. Cannabis could be the potential causative agent in pancreatitis categorized as idiopathic pancreatitis. Cannabis has also been associated with increased post endoscopic retrograde cholangiopancreatography pancreatitis. The endocannabinoid system consists of endogenous cannabinoids, cannabinoid receptors mediated by G protein-coupled receptors CB1, CB2, and enzymes. CBD treatment significantly reduces the level of cytokines involved in the immune response, such as interleukin IL -4, which inhibits T helper type 1 cells differentiation, and IL-5, which causes eosinophilic maturation. They also decrease T helper type 17 inflammatory autoimmune phenotype, downregulate the expression of pathogenic IL and IL-6, and increase anti-inflammatory cytokines IL CB1 activation is associated with fibrosis, and CB2 is associated with antifibrogenic activities in the pancreas. There have been contradicting evidence regarding the effect of the endocannabinoid system on pancreatitis. Matsuda et al \[ 21 \] have reported improved survival of rats with acute pancreatitis with downregulation of the endocannabinoid system using a CB1 receptor inhibitor AM On the contrary, Michalski et al \[ 23 \] and Li et al \[ 24 \] showed that synthetic agonists of cannabinoid receptors HU and O have therapeutic potential in acute pancreatitis. The first endocannabinoid was derived from arachidonoyl ethanolamide, which comes from the word anandamide, or internal bliss in Sanskrit. Anandamide inhibits the proliferation of lymphocytes and tumor necrosis factor activities. Anandamide has been reported to have a biphasic effect on acute pancreatitis through the sensory nerves. Studies have shown that administration of anandamide before the induction of pancreatitis is associated with aggravation of pancreatic damage, while administration after the induction of pancreatitis is associated with reduced severity. Studies have also shown that cannabis users who drink alcohol have decreased acute and chronic pancreatitis. Diagnosis of acute pancreatitis is based on clinical, laboratory, and imaging results. The unknown confounding factor includes the body habitus of the patient and the experience of the radiologist, which could also play a role in the reporting of the imaging findings. Ultrasound although is one of the first tests to perform upon admission, the utility of this study is usually reserved to confirm or exclude the presence of stones and biliary dilation. In our study, another important finding is that all the patients recovered from acute episodes of pancreatitis once cannabis was discontinued. The patient population being younger, male, and lower body mass index might be a few factors that could potentially make the case fatality rate potentially to zero. A recent study has shown that cannabis-induced pancreatitis is associated with lower age-adjusted morbidity, mortality, and hospitalization cost compared to noncannabis-exposed patients. Cannabis could have a potential role in pain management for chronic pancreatitis. Medical cannabis use in 8 patients with chronic pancreatitis was associated with a reduction in daily opiate dose, hospitalization, and emergency room visits. Our analysis has several limitations: the sample size is small as most of the studies previously reported are all case reports and series, missing or incomplete data relevant for inclusion of the articles, reports with pancreatitis of other etiologies, and idiopathic is another etiology of pancreatitis, which cannot be ruled out in patients with cannabis-induced pancreatitis. In conclusion, a large number of cases of cannabis-induced acute pancreatitis have been reported since the legalization of cannabis consumption. An excellent social history is essential while assessing the intake of cannabis and its potential cause as pancreatitis. Physicians and health care providers need to be aware of such complications of cannabinoids, which have not been well reported until now and warrant further large-scale studies for possible pathophysiology and outcomes. Acute pancreatitis as a rare adverse event among cannabis users: a systematic review. Medicine ; e All data relevant to the study are included in the article or uploaded as supplementary information. As all the data were taken from published literature from database. Hence, there was no requirement for ethical approval by any institute. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Medicine Baltimore. Find articles by Vikash Jaiswal. Find articles by Dattatreya Mukherjee. Find articles by Nitya Batra. Find articles by FNU Ruchika. Find articles by Ammu Thampi Susheela. Find articles by Jia Ee Chia. Deblina Mukherjee g Department of Medicine, St. Find articles by Deblina Mukherjee. Find articles by Sidra Naz. Find articles by Aguilera-Alvarez Victor. Find articles by Nishan Babu Pokhrel. Find articles by David Song. Find articles by Tasur Seen. Find articles by Talal Almas. Find articles by Mohanmad Abou Saleh. Find articles by Amandeep Singh Bansrao. Find articles by Emad Mansoor. Published by Wolters Kluwer Health, Inc. Open in a new tab. DM and NB contributed equally and are joint second authors. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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