Combined THC/CBD Extracts for MS Spasticity: What the Clinical Trials Show
A systematic review of six randomized trials found a trend toward reduced spasticity with THC/CBD extracts in MS patients, with significant subjective improvement but no significant changes on objective measures.
Quick Facts
What This Study Found
Six randomized controlled trials of combined THC and CBD extracts for MS-related spasticity were systematically reviewed.
A consistent trend of reduced spasticity in treated patients was observed across studies. However, the pattern of results differed between measurement types.
Objective measures of spasticity (clinical scales, physiological tests) showed improvement trends but no statistically significant changes.
Subjective assessments of symptom relief often showed statistically significant improvement.
Adverse events were reported in every study, but combined THC/CBD extracts were generally considered well-tolerated.
Key Numbers
Six RCTs were included. All six reported adverse events. Subjective measures often showed significant improvement. Objective measures showed trends but no significant changes.
How They Did This
Systematic review of MEDLINE/PubMed, Ovid, and CENTRAL databases for randomized controlled trials using combined THC and CBD extracts with pre- and post-treatment spasticity assessments. Six studies met inclusion criteria.
Why This Research Matters
The disconnect between subjective and objective spasticity measures raises important questions about what outcomes matter most. Patients may experience meaningful relief even when clinical scales do not detect significant changes.
The Bigger Picture
This review documented the evidence base at the time Sativex was being considered for regulatory approval. The subjective-objective disconnect is a recurring theme in cannabis therapeutics research and raises questions about outcome measurement in clinical trials.
What This Study Doesn't Tell Us
Only six studies met inclusion criteria. Variation in outcome measures across studies made direct comparison difficult. The review was limited to combined THC/CBD extracts, excluding other cannabinoid preparations.
Questions This Raises
- ?Why do subjective and objective spasticity measures diverge?
- ?Are current objective measures sensitive enough to detect meaningful changes?
- ?Should regulatory decisions prioritize patient-reported outcomes?
Trust & Context
- Key Stat:
- Subjective improvement was significant; objective measures showed trends but not significance
- Evidence Grade:
- Systematic review of six RCTs. The included trials varied in design and outcome measures, limiting the strength of combined conclusions.
- Study Age:
- Published in 2009. Sativex has since been approved in multiple countries for MS spasticity based on accumulating evidence, including larger subsequent trials.
- Original Title:
- Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review.
- Published In:
- BMC neurology, 9, 59 (2009)
- Authors:
- Lakhan, Shaheen E(2), Rowland, Marie
- Database ID:
- RTHC-00367
Evidence Hierarchy
Analyzes all available research on a topic using a structured method.
What do these levels mean? →Frequently Asked Questions
Does Sativex help with MS spasticity?
This review found patients reported meaningful improvement, but objective clinical measures did not show statistically significant changes. Subsequent larger trials have provided additional data, and Sativex has been approved for MS spasticity in several countries.
Why would patients feel better if objective measures do not change?
Spasticity is a complex symptom. Objective measures like the Ashworth scale may not capture all aspects of what patients experience. Reduced pain, improved comfort, and better sleep quality can all contribute to subjective improvement even if muscle tone measurements appear unchanged.
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Cite This Study
https://rethinkthc.com/research/RTHC-00367APA
Lakhan, Shaheen E; Rowland, Marie. (2009). Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review.. BMC neurology, 9, 59. https://doi.org/10.1186/1471-2377-9-59
MLA
Lakhan, Shaheen E, et al. "Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review.." BMC neurology, 2009. https://doi.org/10.1186/1471-2377-9-59
RethinkTHC
RethinkTHC Research Database. "Whole plant cannabis extracts in the treatment of spasticity..." RTHC-00367. Retrieved from https://rethinkthc.com/research/lakhan-2009-whole-plant-cannabis-extracts
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.