No strong evidence to back use of cannabis extract in multiple sclerosis

December 12, 2012, British Medical Journal

There is no strong evidence to back the use of cannabis extract in the treatment of Multiple Sclerosis (MS), concludes a review of the available evidence on the first licensed preparation, published in the December issue of Drug and Therapeutics Bulletin (DTB).

Sativex, in the form of a mouth spray, contains the principal extracts—dronabinol and —found in the leaf and flower of the cannabis plant. It is the first cannabinoid preparation to be licensed for use in the treatment of muscle spasms in MS.

MS is estimated to affect around 60,000 people in England and Wales, and around one in every 1000 people will develop the condition in the UK.

An increase in , or spasticity is a common symptom of the condition, causing involuntary spasms, , disturbed sleep, and pain.

Complex combinations of drugs are sometimes needed to manage spasticity, but they don't work that well and have a range of unpleasant side effects.

Sativex is intended for use as a second line treatment in patients in whom these other options have failed. But the DTB review found that the trial data on which the success of Sativex is based, are limited.

Overall, the trials, on which the drug's approval was based, did show a small difference in the numbers of patients who in whom symptoms abated compared with those taking a dummy (placebo) preparation.

But in many of these studies, Sativex was used for relatively short periods—from six weeks to four months. And none included an with which the effects of Sativex could be compared.

Two of the trials included doses that exceeded the 12 daily sprays for which the preparation is licensed. One trial did not have sufficient numbers of participants to validate the results.

A third trial, which was properly designed, and did have sufficient numbers of participants, did not find any significant difference in between those who took Sativex and those who didn't.

The preparation is also expensive, notes DTB, and costs around 10 times as much as other drugs used for the secondary treatment of MS .

As yet, the body that advised the NHS on its use of treatments, the National Institute for Health and Clinical Excellence (NICE) has not offered any advice on the use of cannabis extract either, although it is set to do so.

But the DTB review says that the strength of the evidence is insufficient to warrant its routine use. "We believe that such limitations make it difficult to identify the place of this product in clinical practice," it concludes. Commenting on the review, GP and DTB editor, James Cave, said the findings of the review were "disappointing."

"MS is a serious and disabling condition, and it would be great to say that this drug could make a big difference, but the benefit is only modest," he said.

Explore further: Cannabis extract eases muscle stiffness typical of multiple sclerosis

More information: What place for cannabis extract in MS? DTB Vol 50, No 12 December 2012

Related Stories

Cannabis extract eases muscle stiffness typical of multiple sclerosis

October 9, 2012
Cannabis seems to ease the painful muscle stiffness typical of multiple sclerosis, indicate phase III trial results, published in the Journal of Neurology Neurosurgery and Psychiatry.

Little evidence that insect bite remedies work

April 11, 2012
There is little evidence that over the counter remedies for simple insect bites actually work, and in most cases, no treatment at all will suffice, concludes an evidence review in the April Drug and Therapeutics Bulletin ...

Added benefit of Cannabis sativa for spasticity due to multiple sclerosis is not proven

September 17, 2012
An extract from the plant Cannabis sativa (trade name Sativex) was approved in May 2011 for patients suffering from moderate to severe spastic paralysis and muscle spasms due to multiple sclerosis (MS). In an early benefit ...

Smoked cannabis can help relieve muscle tightness and pain in people with multiple sclerosis

May 14, 2012
People with multiple sclerosis may find that smoked cannabis provides relief from muscle tightness — spasticity — and pain, although the benefits come with adverse cognitive effects, according to a new study published ...

Recommended for you

Protein droplets keep neurons at the ready and immune system in balance

August 15, 2018
Inside cells, where DNA is packed tightly in the nucleus and rigid proteins keep intricate transport systems on track, some molecules have a simpler way of establishing order. They can self-organize, find one another in crowded ...

Research reveals that what we see is not always what we get

August 15, 2018
Researchers are helping to explain why some people anticipate and react to fast-moving objects much quicker than others.

Self-control develops gradually in adolescent brain

August 15, 2018
Different parts of the brain mature at different times, which may help to explain impulsive behaviors in adolescence, suggest researchers from Penn State and the University of Pittsburgh.

New research suggests it's all about the bass

August 15, 2018
When we listen to music, we often tap our feet or bob our head along to the beat – but why do we do it? New research led by Western Sydney University's MARCS Institute suggests the reason could be related to the way our ...

New approach to treating chronic itch

August 15, 2018
Researchers at the University of Zurich have discovered a new approach to suppressing itch by targeting two receptors in the spinal cord with the right experimental drug. In a series of experiments in mice and dogs, they ...

Immune cells in the brain have surprising influence on sexual behavior

August 14, 2018
Researchers have found a surprising new explanation of how young brains are shaped for sexual behavior later in life.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.