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Multiple Sclerosis

There are major studies supporting the use of cannabinoids for the treatment of MS and its associated symptoms. The current clinical studies have found that generally a 1:1 ratio of THC:CBD has been the most effective combination for spasticity and pain.

One standard preparation, Sativex (or nabiximols), is an oromucosal form of cannabis-based medicine containing 2.7mg of THC and 2.5mg CBD plus terpenoids per spray. Sativex has been successfully approved in 29 countries for the treatment of spasticity in MS, as it has been the most rigorous cannabis-based medicine tested for MS symptom relief. Under GW Pharmaceuticals, Sativex met the standards of safety, efficacy and consistency required of any pharmaceutical. Right now, Sativex is currently waiting FDA approval as a treatment for cancer pain.

Key Research Findings:

Below are some of the major review articles, clinical studies and their conclusions:

Chapter Highlights: The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. (2017)
  • “The National Academies of Science, Engineering & Medicine rigorously reviewed over 10,000 scientific studies related to the health effects of cannabis and cannabinoids. They reported that there is conclusive/ substantial evidence that short-term use of oral cannabinoids in adults with multiple sclerosis (MS)-related spasticity showed great improvement in patient-reported spasticity symptoms.” 
A randomized, double‐blind, placebo‐controlled, parallel‐group, enriched‐design study of nabiximols*(Sativex®), as add‐on therapy, in subjects with refractory spasticity caused by multiple sclerosis. (2011)
  • “Cannabis-based medicines are clinically effective treatments for spasticity in MS.” 
Who benefits most from THC: CBD spray? Learning from clinical experience. (2014)
  • “From the outcomes of the treatment of this small sample of different MS spasticity typologies, it can be said that in clinical practice THC:CBD oromucosal spray is an effective and viable option for moderate to severe spasticity MS patients resistant to existing therapies.”

Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis. (2016)
  • “Efficacy of THC-CBD oromucosal spray in MS symptom management has been proven in randomized, controlled clinical studies and its effectiveness confirmed in observational studies.  It has been shown to have a good safety profile and is generally well tolerated. THC-CBD oromucosal spray is able to respond to individual patient’s needs through a self-adaptable dosage form.”
Cannabinoids control spasticity and tremor in a multiple sclerosis model. (2000)
  • “These data provide compelling evidence that CB [cannabinoid] receptors are involved in the control of spasticity in an environment of existing neurological damage…”
A Phase I, open-label, randomized, crossover study in three parallel groups to evaluate the effect of Rifampicin, Ketoconazole, and Omeprazole on the pharmacokinetics of THC/CBD oromucosal spray in healthy volunteers. (2013)
  • “THC/CBD spray was generally well tolerated when given alone, illustrated by the fact that there were no serious AEs [Adverse Events] during the study.”
Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis. (2006)
  • “In conclusion, this study has shown that Cannabis-Based Medicine (Sativex) can be used in the long-term without tolerance or intoxication, and with maintenance of subjective symptomatic relief.”
A placebo-controlled, parallel-group, randomized withdrawal study of subjects with symptoms of spasticity due to multiple sclerosis who are receiving long-term Sativex®(nabiximols). (2012)
  • “This study therefore provides further evidence of the maintenance of long-term efficacy of Sativex [Cannabis-based medicine] as an add-on therapy in the treatment of MS spasticity, in patients.”