Unitat de Neuroimmunologia Clinica, CEM-Cat, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain.
Expert Rev Neurother. 2011 May;11(5):627-37. doi: 10.1586/ern.11.47. Epub 2011 Apr 1.
People with multiple sclerosis may present with a wide range of disease symptoms during the evolution of the disease; among these, spasticity can have a marked impact on their well-being and quality of life. Symptom control, including spasticity, remains a key management strategy to improve the patient's well-being and functional status. However, available drug therapies for spasticity sometimes have limited benefit and they are often associated with poor tolerability. Sativex is a 1:1 mix of 9-delta-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, which is available as an oromucosal spray. Clinical experience with Sativex in patients with multiple sclerosis is accumulating steadily. Results from randomized, controlled trials have reported a reduction in the severity of symptoms associated with spasticity, leading to a better ability to perform daily activities and an improved perception of patients and their carers regarding functional status when Sativex was added to the current treatment regimen. Adverse events such as dizziness, diarrhea, fatigue, nausea, headache and somnolence occur quite frequently with Sativex, but they are generally of mild-to-moderate intensity and their incidence can be markedly reduced by gradual 'uptitration'. In summary, initial well-controlled studies with Sativex oromucosal spray administered as an add-on to usual therapy have produced promising results and highlight encouraging avenues for future research.
多发性硬化症患者在疾病进展过程中可能会出现多种疾病症状；其中，痉挛会对他们的幸福感和生活质量产生显著影响。症状控制，包括痉挛，仍然是改善患者幸福感和功能状态的关键管理策略。然而，痉挛的可用药物治疗有时益处有限，并且它们通常与较差的耐受性相关。Sativex 是一种从克隆大麻品种中提取的 9-Δ-四氢大麻酚和大麻二酚的 1:1 混合物，可用作口腔粘膜喷雾。在多发性硬化症患者中使用 Sativex 的临床经验正在稳步积累。随机对照试验的结果报告称，添加到当前治疗方案中，可减轻与痉挛相关的症状的严重程度，从而提高日常活动能力，并改善患者及其护理人员对功能状态的感知。头晕、腹泻、疲劳、恶心、头痛和嗜睡等不良反应在 Sativex 中相当常见，但它们通常为轻度至中度，通过逐渐“滴定”可显著降低其发生率。总之，Sativex 口腔粘膜喷雾作为附加治疗的初始良好对照研究产生了有希望的结果，并为未来的研究提供了令人鼓舞的途径。
