Multiple Sclerosis
Study register · detail Kohortenstudie · Multiple Sclerosis · 2015

Effectiveness and Tolerability of THC/CBD Oromucosal Spray for Multiple Sclerosis Spasticity in Italy: First Data from a Large Observational Study.

Clear benefit GRADE Low 21 citations
Samplen = 322 Pat.
Duration3 months
EndpointNRS
Blindingn.a.
DesignKohortenstudie
Cannabinoidkombination
THC:CBD1:1
Routeoromukosal
Key finding

THC/CBD spray significantly reduced MS spasticity: NRS score decreased by 19,1% (p<0,0001), modified Ashworth score from 2,6 to 2,3 points (p<0,0001), 24,6% of patients showed ≥30% improvement.

Summary

MOVE-2 interim analysis Italy: n=322 MS patients with treatment-resistant spasticity under THC:CBD oromucosal spray (Sativex®). Baseline→Month 3: NRS score -19,1% (-1,6 points, p<0,0001), modified Ashworth score 2,6→2,3 (p<0,0001). 24,6% clinically relevant responders (≥30% NRS improvement, p<0,001). Mean dose 5,1±2,6 sprays/day (Month 3). 13,1% reported ≥1 adverse event; most common: dizziness (5,6%), confusion (2,5%), nausea (1,25%).

P
PopulationAdults with treatment-resistant MS spasticity, n=322, from Italy (58,3% female, mean age 51,1 years)
I
InterventionTHC/CBD oromucosal spray (Sativex), mean dose 5,1–6,1 sprays/day
O
OutcomeNRS score decreased by 19,1% (−1,6 points, p<0,0001); modified Ashworth score from 2,6 to 2,3 (p<0,0001); 24,6% clinically relevant responders (≥30% NRS improvement, p<0,001)
Confidence in the evidence
Low

The second of four GRADE levels, the effect estimate is of limited reliability.

Quality profile
Sample size
Blinding
Effect size Clear benefit
Citations / year
Authors
Trojano M, Vila C
DOI 10.1159/000441619
Design: Kohortenstudie
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Abstract
Background: The prospective, non-interventional Mobility Improvement (MOVE) 2 study was designed to provide real life data on clinical outcomes of patients with treatment-resistant multiple sclerosis (MS) spasticity receiving routine treatment with tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex(R)), subsequent to its approval in European countries. Methods: This interim analysis reports on MOVE 2 patients from Italy. Results: Interim data from 322 patients (58.3% female; mean age 51.1 +/- 10.2 years) were analyzed. From baseline to month 3 of treatment (Visit 3), the mean 0-10 Numerical Rating Scale (NRS) score decreased by -19.1% (-1.6 points, p < 0.0001) and the mean modified Ashworth score decreased from 2.6 to 2.3 points (p < 0.0001). At Visit 3, 24.6% of 203 patients with available data were clinically relevant responders (>/=30% improvement from baseline NRS score; p < 0.001 vs. baseline). The mean reported dose of THC:CBD oromucosal spray was 6.1 +/- 2.5 sprays/day at Visit 1 (1 month) and 5.1 +/- 2.6 sprays/day at Visit 3 (range 1-12 sprays/day at both timepoints). Forty-one (13.1%) patients reported at least one adverse event (AE), which included 3 serious AEs (1 unrelated). AEs with an incidence >/=1% were dizziness (5.6%), confusion (2.5%), nausea (1.25%) and somnolence (1.25%). Conclusion: In everyday clinical practice in Italy, THC:CBD oromucosal spray provided symptomatic relief of MS spasticity with good tolerability in a relevant number of previously resistant patients.

The impediment to action advances action. — Marcus Aurelius