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

Even without nudging blood pressure up, high-salt diet hobbles the brain

January 16, 2018
A high-salt diet may spell trouble for the brain—and for mental performance—even if it doesn't push blood pressure into dangerous territory, new research has found.

Brain imaging predicts language learning in deaf children

January 15, 2018
In a new international collaborative study between The Chinese University of Hong Kong and Ann & Robert H. Lurie Children's Hospital of Chicago, researchers created a machine learning algorithm that uses brain scans to predict ...

Preterm babies may suffer setbacks in auditory brain development, speech

January 15, 2018
Preterm babies born early in the third trimester of pregnancy are likely to experience delays in the development of the auditory cortex, a brain region essential to hearing and understanding sound, a new study reveals. Such ...

BOLD view of white matter

January 15, 2018
The brain consists of gray matter, which contains the nerve cell bodies (neurons), and white matter, bundles of long nerve fibers (axons) that until recently were considered passive transmitters of signals between different ...

Does an exploding brain network cause chronic pain?

January 12, 2018
A new study finds that patients with fibromyalgia have brain networks primed for rapid, global responses to minor changes. This abnormal hypersensitivity, called explosive synchronization (ES), can be seen in other network ...

An innovative PET tracer can measure damage from multiple sclerosis in mouse models

January 12, 2018
The loss or damage of myelin, a cellular sheath that surrounds and insulates nerves, is the hallmark of the immune-mediated neurological disorder multiple sclerosis (MS). When segments of this protective membrane are damaged, ...

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.