A new multiple sclerosis spasticity treatment option: effect in everyday clinical practice and cost-effectiveness in Germany.
Sativex® (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain), a cannabinoid oromucosal spray containing a 1:1 ratio of 9-δ-tetrahydrocannabinol and cannabidiol, has been licensed in Germany since July 2011 as add-on therapy for moderate-to-severe multiple sclerosis (MS) treatment-resistant spasticity symptoms. The 'MOVE 2' study evaluated clinical outcomes, treatment satisfaction, quality of life (QoL) and provision of care in MS patients with spasticity receiving Sativex in everyday clinical practice. Data from 300 patients were collected from 42 specialized MS centers across Germany and were available for this analysis. Assessments, including the MS spasticity 0-10 numerical rating scale, modified Ashworth scale, patients' and physicians' clinical impressions, and QoL scales were rated at baseline and at 1 and 3 months after starting treatment with Sativex. Sativex provided relief of MS-related spasticity in the majority of patients who were previously resistant to treatment. In addition, clear improvements were noted in MS spasticity-associated symptoms (e.g., sleep quality, bladder function and mobility), activities of daily living and QoL. Sativex was generally well tolerated. The majority of patients (84%) reported no adverse events, and there was only a limited risk of serious adverse reactions. Furthermore, based on data from Sativex clinical trials, a Markov model-based analysis has shown that Sativex is a cost-effective treatment option for patients with MS spasticity in Germany.
Neurological Rehabilitation Center Quellenhof, Kuranlagenallee 2, 75323 Bad Wildbad, Germany. peter.flachenecker@sana.de
Peter
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Flachenecker
D018726:Anti-Dyskinesia Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002185:Cannabidiol; D063386:Cannabinoid Receptor Agonists / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D013759:Dronabinol; D004338:Drug Combinations; D016527:Drug Costs; D004351:Drug Resistance; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology; D009128:Muscle Spasticity / Q000209:etiology / Q000517:prevention & control*; D010820:Physicians; D010936:Plant Extracts / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D011788:Quality of Life
D018726:Anti-Dyskinesia Agents; D063386:Cannabinoid Receptor Agonists; D004338:Drug Combinations; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols