A review described how endocannabinoid levels change in MS and found that Sativex (1:1 THC:CBD) dose-dependently reduced MS-related spasticity in mice as effectively as the standard treatment baclofen.
Read this if you have MS-related spasticity and are interested in cannabis-based treatment options.
Sativex matched baclofen effectiveness for MS spasticity in mouse model
What the researchers found
The review examined the role of endocannabinoids in MS-related muscular dysfunction and the therapeutic potential of Sativex (nabiximols), containing equal parts THC and CBD.
Endocannabinoid levels were found to be altered in both animal models of MS and in cerebrospinal fluid samples from MS patients. Anandamide and 2-AG levels changed in different and sometimes opposing ways, suggesting complex regulatory involvement.
In an experimental mouse model of MS-related spasticity, Sativex dose-dependently improved hind limb flexion and stiffness. At 10 mg/kg, Sativex was as effective as baclofen at 5 mg/kg, the most widely used anti-spasticity medication.
The author noted that Sativex acted as an "endocannabinoid system modulator" rather than simply activating cannabinoid receptors.
Why it matters
Demonstrating that a cannabis-based medicine could match the effectiveness of established anti-spasticity treatment in an animal model provided strong preclinical support for clinical development.
The numbers in context
Sativex at 10 mg/kg was as effective as baclofen at 5 mg/kg for MS-related spasticity in mice. THC:CBD ratio was 1:1.
How the study worked
Expert review examining endocannabinoid pathways in MS-related spasticity, including animal model data and patient cerebrospinal fluid studies, with focus on Sativex preclinical efficacy data.
What this study cannot tell us
Mouse model of spasticity may not perfectly replicate human MS. Single expert review perspective. The "modulator" mechanism was described conceptually rather than with detailed molecular evidence.
How to read the evidence
Expert review with preclinical efficacy data and patient biomarker evidence.
When this study was published
Published in 2011. Sativex has since been approved in multiple countries for MS-related spasticity.
The bigger picture
This work contributed to the evidence base that supported Sativex approval for MS-related spasticity in multiple countries.
Questions still open
- How does CBD contribute to anti-spasticity effects alongside THC? Could the endocannabinoid system be targeted for other neurodegenerative conditions beyond MS?
Common questions
Can cannabis-based medicine help with MS stiffness?
What is Sativex?
Read the original research
Endocannabinoid pathways and their role in multiple sclerosis-related muscular dysfunction.
Expert review of neurotherapeutics, 11(4 Suppl), 9-14
Citation
Di Marzo, Vincenzo. (2011). Endocannabinoid pathways and their role in multiple sclerosis-related muscular dysfunction.. Expert review of neurotherapeutics, 11(4 Suppl), 9-14.
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