Expert review finds nabiximols effective for MS spasticity when first-line drugs fail

An expert review of over 7,500 patients across 33 studies found nabiximols (THC/CBD spray) is safe and effective for treating MS-related spasticity that does not respond to first-line oral medications, while finding no scientific evidence for smoked marijuana in MS.

Fragoso, Yara Dadalti et al.·Expert review of neurotherapeutics·2020·Strong EvidenceReview
RTHC-02557ReviewStrong Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Strong Evidence
Sample
N=7,500

What This Study Found

Evidence-based data from 33 studies with over 7,500 patients supports nabiximols for MS-related spasticity, pain, and urinary symptoms. However, the review found no scientific evidence supporting smoked marijuana for MS patients.

Key Numbers

33 studies reviewed, over 7,500 patients. 12 studies from the UK, 11 from Italy. Nabiximols treats spasticity, pain, and urinary symptoms.

How They Did This

Expert review examining published clinical evidence on cannabis-derived treatments for MS, including 33 studies (12 from the UK, 11 from Italy) involving nabiximols.

Why This Research Matters

The review distinguishes between evidence-based cannabis medicine (nabiximols) and unregulated marijuana smoking, providing clinicians with clear guidance on what cannabis-related treatments have actual support.

The Bigger Picture

Despite growing interest in medical marijuana for MS, the evidence specifically supports pharmaceutical-grade nabiximols rather than smoked cannabis, highlighting the gap between patient expectations and scientific evidence.

What This Study Doesn't Tell Us

Expert review rather than systematic review or meta-analysis. Legislation, cost, and prescribing restrictions limit real-world access and experience with nabiximols in many countries.

Questions This Raises

  • ?Why has smoked marijuana bypassed traditional clinical trials for MS?
  • ?Would broader access to nabiximols reduce use of unregulated cannabis products among MS patients?

Trust & Context

Key Stat:
33 studies, 7,500+ patients support nabiximols for MS spasticity
Evidence Grade:
Strong: large evidence base across 33 studies and multiple countries, though presented as an expert review rather than systematic review.
Study Age:
Published in 2020 in Expert Review of Neurotherapeutics.
Original Title:
Cannabis and multiple sclerosis.
Published In:
Expert review of neurotherapeutics, 20(8), 849-854 (2020)
Database ID:
RTHC-02557

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

What is nabiximols?

Nabiximols (brand name Sativex) is a pharmaceutical spray containing a standardized ratio of THC and CBD extracted from cannabis plants. It is sprayed under the tongue and is approved in some countries for MS-related spasticity.

Can smoking marijuana help MS?

According to this expert review, there is no scientific evidence that smoking marijuana provides benefits for MS patients. The evidence specifically supports nabiximols, a pharmaceutical-grade product, not smoked cannabis.

Read More on RethinkTHC

Cite This Study

RTHC-02557·https://rethinkthc.com/research/RTHC-02557

APA

Fragoso, Yara Dadalti; Carra, Adriana; Macias, Miguel Angel. (2020). Cannabis and multiple sclerosis.. Expert review of neurotherapeutics, 20(8), 849-854. https://doi.org/10.1080/14737175.2020.1776610

MLA

Fragoso, Yara Dadalti, et al. "Cannabis and multiple sclerosis.." Expert review of neurotherapeutics, 2020. https://doi.org/10.1080/14737175.2020.1776610

RethinkTHC

RethinkTHC Research Database. "Cannabis and multiple sclerosis." RTHC-02557. Retrieved from https://rethinkthc.com/research/fragoso-2020-cannabis-and-multiple-sclerosis

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.