Patient-reported benefits from nabiximols treatment in multiple sclerosis-related spasticity exceed conventional measures

Neurodegener Dis Manag. 2024 Feb;14(1):11-20. doi: 10.2217/nmt-2023-0040. Epub 2024 Feb 6.

Abstract

Aim: This prospective, multicenter, open-label, noninterventional 12-week study investigated the effectiveness and tolerability of add-on nabiximols oromucosal spray (Sativex®) in the real-world setting in Germany. Patients & methods: The main analysis set comprised 51 adult patients (49 nabiximols responders) with multiple sclerosis (MS) spasticity. Results: The mean overall goal attainment scale score (primary outcome measure) increased by 46% from baseline to week 12 (35.2 vs 51.4; p < 0.001). Mean gait speed was improved by 23% at 4 and 12 weeks. Clinically meaningful improvements in mean 0-10 numerical rating scale scores for spasticity, pain, sleep quality and urinary bladder dysfunction were recorded at 4 and 12 weeks. Conclusion: Nabiximols is a useful therapeutic option for patients with MS spasticity.

Keywords: goal attainment scale; multiple sclerosis; nabiximols oromucosal spray; patient-reported outcomes; spasticity.

Plain language summary

People with multiple sclerosis (MS) spasticity experience a variety of symptoms and have individual expectations about a new treatment. This study investigated patients' perceptions about the effectiveness and tolerability of nabiximols oromucosal spray (Sativex®) when added to current medications for spasticity. Common treatment goals for patients (n = 51) were less pain, better walking and improved sleep. After 12 weeks of treatment, 62% of selected treatment goals were achieved ‘as expected’ or ‘better than expected’ and 65% of patients considered their spasticity to be ‘much improved’. Meaningful improvements were recorded in spasticity-related symptoms of pain, sleep quality and bladder problems. Few side effects were reported. Nabiximols may be useful for MS patients with a poor response to usual spasticity medications.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cannabidiol* / therapeutic use
  • Dronabinol / therapeutic use
  • Drug Combinations
  • Humans
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / drug therapy
  • Muscle Spasticity / drug therapy
  • Muscle Spasticity / etiology
  • Patient Reported Outcome Measures
  • Plant Extracts / therapeutic use
  • Prospective Studies
  • Treatment Outcome

Substances

  • Cannabidiol
  • Dronabinol
  • Drug Combinations
  • nabiximols
  • Plant Extracts