Vermersch Patrick, Trojano Maria
University of Lille, CHU Lille, LIRIC-INSERM U995, FHU Imminent, Lille, France.
Eur Neurol. 2016;76(5-6):216-226. doi: 10.1159/000449413. Epub 2016 Oct 13.
Tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray (Sativex®) is an add-on therapy for moderate-to-severe multiple sclerosis (MS)-related drug-resistant spasticity (MSS).
The MOVE-2 EU study collected data from everyday clinical practice concerning the effectiveness and tolerability of THC:CBD.
This was an observational, prospective, multicentre, non-interventional study. Patients with resistant MSS prescribed add-on THC:CBD oromucosal spray according to approved labelling, were followed for 3 months. After 1 month, only responders (≥20% improvement in spasticity) continued treatment. The main endpoints were the evolution of MSS and associated symptoms, quality of life (QoL) and tolerability.
Four hundred and thirty three patients (55% female) were recruited (98% in Italy). The mean duration of MSS was 7.4 years and baclofen was used by 78.1% of participants. Three hundred and forty nine participants continued with THC:CBD oromucosal spray after 1 month, and 281 after 3 months. THC:CBD mean dosage was 6 sprays/day. MSS scores and spasticity-related symptoms (spasms, fatigue, pain, sleep quality and bladder dysfunction) were significantly improved by THC:CBD at 3 months, as were activities of daily living, and QoL (EQ-5D VAS). Adverse events, none of which were severe or serious, were reported by 10.4% of patients.
In everyday clinical practice, THC:CBD oromucosal spray provided symptomatic relief of MSS and related troublesome symptoms.
四氢大麻酚:大麻二酚(THC:CBD)口腔黏膜喷雾剂(Sativex®)是中重度多发性硬化症(MS)相关耐药性痉挛(MSS)的附加治疗药物。
MOVE-2欧盟研究收集了日常临床实践中有关THC:CBD有效性和耐受性的数据。
这是一项观察性、前瞻性、多中心、非干预性研究。根据批准的标签为耐药性MSS患者开具附加THC:CBD口腔黏膜喷雾剂,并对其进行3个月的随访。1个月后,仅对有反应者(痉挛改善≥20%)继续进行治疗。主要终点为MSS及其相关症状的演变、生活质量(QoL)和耐受性。
共招募了433例患者(55%为女性)(98%来自意大利)。MSS的平均病程为7.4年,78.1%的参与者使用过巴氯芬。1个月后,349名参与者继续使用THC:CBD口腔黏膜喷雾剂,3个月后为281名。THC:CBD的平均剂量为每天6喷。3个月时,THC:CBD显著改善了MSS评分以及与痉挛相关的症状(痉挛、疲劳、疼痛、睡眠质量和膀胱功能障碍),日常生活活动和QoL(EQ-5D视觉模拟量表)也得到改善。10.4%的患者报告了不良事件,但均不严重。
在日常临床实践中,THC:CBD口腔黏膜喷雾剂可缓解MSS及相关的困扰症状。