title: Advances in the management of MS spasticity: recent observational studies.
abstract: BACKGROUND
  Clinical trials demonstrate the efficacy and tolerability of an intervention under experimental conditions, but information on use under daily practice conditions is required to confirm the effectiveness and safety of new management options.
  
  
  CONCLUSIONS
  Clinical outcomes for THC:CBD oromucosal spray (Sativex®) in patients with treatment-resistant MS spasticity have been collected in post-marketing safety registries from the UK and Germany, a safety study from Spain and two observational studies from Germany, including one investigating its effects on driving ability. Collectively, findings from daily practice support the long-term effectiveness and safety of THC:CBD oromucosal spray. The proportion of patients with a clinically relevant response (≥30% improvement from baseline on the spasticity 0-10 Numerical Rating Scale) at 3 months was similar to that reported in a large enriched-design pivotal clinical trial (41 vs. 36%). There was no evidence of abuse/misuse or other adverse events of special interest with a cannabis-based medicine and no impairment of driving ability. In actual clinical practice, average daily doses were ∼25% lower than those used in clinical trials. Key Messages: Observational data and real world experience reinforce the efficacy and safety of THC:CBD oromucosal spray as reported in phase III clinical trials. © 2014 S. Karger AG, Basel.
authors.affiliation: Neurology Department & Institute of Clinical Neurosciences, Regional University Hospital, Málaga, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Fernández
mesh_terms: D002185:Cannabidiol; D013759:Dronabinol; D004338:Drug Combinations; D005858:Germany; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology; D064887:Observational Studies as Topic; D010936:Plant Extracts / Q000627:therapeutic use*; D012042:Registries; D013030:Spain; D006113:United Kingdom
chemical_list: D004338:Drug Combinations; D009125:Muscle Relaxants, Central; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols