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四氢大麻酚:大麻二酚口腔黏膜喷雾剂用于日常实践中与多发性硬化相关的难治性痉挛。

Tetrahydrocannabinol:Cannabidiol Oromucosal Spray for Multiple Sclerosis-Related Resistant Spasticity in Daily Practice.

作者信息

Vermersch Patrick, Trojano Maria

机构信息

University of Lille, CHU Lille, LIRIC-INSERM U995, FHU Imminent, Lille, France.

出版信息

Eur Neurol. 2016;76(5-6):216-226. doi: 10.1159/000449413. Epub 2016 Oct 13.

Abstract

BACKGROUND

Tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray (Sativex®) is an add-on therapy for moderate-to-severe multiple sclerosis (MS)-related drug-resistant spasticity (MSS).

AIM

The MOVE-2 EU study collected data from everyday clinical practice concerning the effectiveness and tolerability of THC:CBD.

METHODS

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.

RESULTS

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.

CONCLUSIONS

In everyday clinical practice, THC:CBD oromucosal spray provided symptomatic relief of MSS and related troublesome symptoms.

摘要

背景

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。

目的

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。

方法

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。

结果

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。

结论

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。

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