Randomized controlled trials confirmed cannabinoid efficacy for MS spasticity, leading to Sativex approval in multiple countries as an add-on treatment for resistant spasticity.
Read this if you have MS spasticity and want to understand the science and evidence behind cannabinoid treatment.
Sativex approved for MS spasticity in multiple countries
What the researchers found
This review covered the biological rationale and clinical evidence for cannabinoids in MS spasticity. Anecdotal evidence of cannabis benefits for spasticity was confirmed by randomized, double-blind, placebo-controlled studies.
Sativex (1:1 THC:CBD oromucosal spray) received approval for MS-related spasticity in various countries based on these trials. The review contextualized this within the broader understanding of cannabinoid biology, including the endocannabinoid system's role in regulating neurotransmission and muscle tone.
The authors positioned Sativex as a valuable addition to the existing spasticity treatment armamentarium, particularly for patients not adequately controlled by conventional medications.
Why it matters
This review provided the scientific justification for using cannabinoids in MS at a time when approvals were being sought in multiple countries. The combination of biological rationale and clinical evidence strengthened the case.
The numbers in context
Sativex approved in multiple countries for MS spasticity. 1:1 THC:CBD ratio. Confirmed by randomized, placebo-controlled trials.
How the study worked
Narrative review of cannabinoid receptor biology, endocannabinoid system physiology, and clinical trial evidence for cannabinoids in MS spasticity.
What this study cannot tell us
Narrative review without systematic methodology. Focused primarily on Sativex rather than other cannabinoid formulations. Treatment effect sizes were modest on average.
How to read the evidence
Narrative review drawing on randomized controlled trial data. Solid evidence base for the specific indication of MS spasticity.
When this study was published
Published in 2012. Sativex is now widely available for MS spasticity in approved countries.
The bigger picture
MS spasticity treatment options were limited, and existing drugs often provided insufficient relief with poor tolerability. Cannabinoids added a new treatment class with a different mechanism of action.
Questions still open
- Are other cannabinoid formulations equally effective? Can biomarkers predict which patients will respond? Would higher doses be more effective, or would side effects limit dosing?
Common questions
Is there good evidence for cannabis treating MS spasticity?
How does it work biologically?
Read the original research
Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity.
Therapeutic advances in neurological disorders, 5(5), 255-66
Citation
Leussink, Verena Isabell; Husseini, Leila; Warnke, Clemens; Broussalis, Erasmia; Hartung, Hans-Peter; Kieseier, Bernd C. (2012). Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity.. Therapeutic advances in neurological disorders, 5(5), 255-66. https://doi.org/10.1177/1756285612453972
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