Sativex Did Not Improve Spasticity Measures or Endocannabinoid Levels in MS Patients
In 20 multiple sclerosis patients, the THC/CBD spray Sativex failed to improve spasticity on clinical or neurophysiological measures and did not alter endocannabinoid system markers.
Quick Facts
What This Study Found
Twenty MS patients used Sativex (a THC/CBD oromucosal spray) and were assessed for changes in spasticity and endocannabinoid system markers.
Sativex failed to improve clinically measured spasticity. It also did not change stretch reflex excitability, a neurophysiological marker of spasticity.
On the biochemical level, Sativex did not affect the synthesis or degradation of the endocannabinoid anandamide. It also did not change the expression of CB1 or CB2 cannabinoid receptors on various types of peripheral lymphocytes.
Key Numbers
20 MS patients were studied. Sativex contains both THC and CBD. No significant changes were found in any measured outcome.
How They Did This
This was an observational study of 20 MS patients receiving Sativex. Researchers measured clinical spasticity, stretch reflex excitability (neurophysiological), anandamide metabolism, and cannabinoid receptor expression on peripheral lymphocytes.
Why This Research Matters
While Sativex has been approved for MS-related pain in some countries, this study found no objective improvement in spasticity, suggesting the drug may not address all MS symptoms equally.
The Bigger Picture
This study highlights the gap between subjective symptom relief (reported in other studies) and objective clinical measurements. A drug can make patients feel better without producing measurable changes on clinical scales, raising questions about which outcomes matter most.
What This Study Doesn't Tell Us
Small sample of only 20 patients. The study did not include a placebo control group. Peripheral lymphocyte markers may not reflect what is happening in the central nervous system.
Questions This Raises
- ?Why does Sativex appear to help some MS symptoms (pain) but not others (spasticity) on objective measures?
- ?Could longer treatment duration produce different results?
- ?Are peripheral endocannabinoid markers relevant to central nervous system effects?
Trust & Context
- Key Stat:
- Zero significant changes across all measured outcomes in 20 MS patients
- Evidence Grade:
- Small uncontrolled observational study (n=20) without placebo comparison.
- Study Age:
- Published in 2009. Subsequent larger trials have provided more nuanced data on Sativex and MS spasticity, with some finding benefits on subjective but not always objective measures.
- Original Title:
- Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis.
- Published In:
- Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 30(6), 531-4 (2009)
- Authors:
- Centonze, Diego(4), Mori, Francesco, Koch, Giacomo, Buttari, Fabio, Codecà, Claudia, Rossi, Silvia, Cencioni, Maria Teresa, Bari, Monica, Fiore, Stefania, Bernardi, Giorgio, Battistini, Luca, Maccarrone, Mauro
- Database ID:
- RTHC-00348
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Does this mean cannabis does not help MS spasticity?
Not necessarily. Other studies have found subjective improvement in spasticity symptoms. This study focused on objective measures, and the disconnect between subjective and objective findings is itself an important research question.
Why were lymphocytes measured in a spasticity study?
Cannabinoid receptors are expressed on immune cells, and researchers wanted to see if Sativex altered the endocannabinoid system in measurable ways. The lack of change in peripheral markers does not rule out central nervous system effects.
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Cite This Study
https://rethinkthc.com/research/RTHC-00348APA
Centonze, Diego; Mori, Francesco; Koch, Giacomo; Buttari, Fabio; Codecà, Claudia; Rossi, Silvia; Cencioni, Maria Teresa; Bari, Monica; Fiore, Stefania; Bernardi, Giorgio; Battistini, Luca; Maccarrone, Mauro. (2009). Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis.. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 30(6), 531-4. https://doi.org/10.1007/s10072-009-0136-5
MLA
Centonze, Diego, et al. "Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis.." Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2009. https://doi.org/10.1007/s10072-009-0136-5
RethinkTHC
RethinkTHC Research Database. "Lack of effect of cannabis-based treatment on clinical and l..." RTHC-00348. Retrieved from https://rethinkthc.com/research/centonze-2009-lack-of-effect-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.