title: Clinical case reviews and poster sessions in multiple sclerosis spasticity: main outcomes and highlights.
abstract: Individuals with multiple sclerosis (MS) spasticity present with a range of symptoms and disability levels that are frequently challenging to manage. Summary : Clinical case reviews in treatment-resistant MS spasticity were presented in five country-specific sessions conducted in parallel at the MS Experts Summit. Attendees at the Norwegian session discussed early response to new treatments for severe spasticity and highlighted the importance of titrating THC:CBD oromucosal spray (Sativex®) when adding it to baclofen. The French group focussed on MS symptoms and patient characteristics that interact with spasticity and agreed on a list of minimum ratings for diagnosis of MS spasticity symptoms. Attendees at the Spanish session concurred that THC:CBD oromucosal spray is effective and well tolerated as add-on therapy in treatment-resistant MS spasticity, particularly for pain, spasms and gait disturbances. The Italian group discussed the use of add-on THC:CBD oromucosal spray and other possible combination therapies for treatment-resistant MS spasticity. Attendees at the German session highlighted the need to address trigger factors for MS spasticity to reduce the potential for impact on activities of daily living (ADL) and quality of life (QoL). Three innovative studies of MS spasticity from the poster session were selected for closer review. The MOVE 1 EU epidemiological study indicated that, across western Europe, patients with MS spasticity continue to have unmet management needs. A literature review demonstrated that symptomatic relief of MS spasticity in patients who respond to THC:CBD oromucosal spray translates into sustainable improvements in ADL and QoL. Enriched-design studies of medications targeting the endocannabinoid system require careful interpretation due to possible pharmacodynamic 'priming', i.e. carry-over effects of successful active treatment during the enrichment phase. Key Messages: Sharing experiences of clinical practice, including experience with the use of THC:CBD oromucosal spray, may be useful to overcome some of the challenges in the overall management of patients with moderate to severe treatment-resistant MS spasticity.
authors.affiliation: Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
authors.forename: Elisabeth G
authors.initials: EG
authors.lastname: Celius
authors.forename: Cecile
authors.initials: C
authors.lastname: Donzé
authors.forename: Guillermo
authors.initials: G
authors.lastname: Izquierdo
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
authors.forename: Dieter
authors.initials: D
authors.lastname: Pöhlau
mesh_terms: D000203:Activities of Daily Living; D002185:Cannabidiol; D017281:Cost of Illness; D013759:Dronabinol; D004338:Drug Combinations; D005060:Europe; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D009125:Muscle Relaxants, Central / Q000009:adverse effects / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life
chemical_list: D004338:Drug Combinations; D009125:Muscle Relaxants, Central; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols