Will this be the answer to the Catch-22 of stroke spasticity?
http://jnnp.bmj.com/content/early/2012/07/11/jnnp-2012-302468.abstract?sid=30873068-9426-415b-8563-d2e773ea3bf2
Abstract
Objective
Multiple sclerosis (MS) is associated with chronic symptoms, including
muscle stiffness, spasms, pain and insomnia. Here
we report the results of the
Multiple Sclerosis and Extract of Cannabis (MUSEC) study that aimed to
substantiate the patient
based findings of previous studies.
Patients and methods
Patients with stable MS at 22 UK centres were randomised to oral
cannabis extract (CE) (N=144) or placebo (N=135), stratified
by centre, walking ability and use
of antispastic medication. This double blind, placebo controlled, phase
III study had a
screening period, a 2 week dose
titration phase from 5 mg to a maximum of 25 mg of tetrahydrocannabinol
daily and a 10 week
maintenance phase. The primary
outcome measure was a category rating scale (CRS) measuring patient
reported change in muscle
stiffness from baseline. Further
CRSs assessed body pain, spasms and sleep quality. Three validated MS
specific patient reported
outcome measures assessed aspects of
spasticity, physical and psychological impact, and walking ability.
Results
The rate of relief from muscle stiffness after 12 weeks was almost twice
as high with CE than with placebo (29.4% vs 15.7%;
OR 2.26; 95% CI 1.24 to 4.13;
p=0.004, one sided). Similar results were found after 4 weeks and 8
weeks, and also for all
further CRSs. Results from the MS
scales supported these findings.
Conclusion
The study met its primary objective to demonstrate the superiority of
CE over placebo in the treatment of muscle stiffness
in MS. This was supported by results
for secondary efficacy variables. Adverse events in participants
treated with CE were
consistent with the known side
effects of cannabinoids. No new safety concerns were observed.
Trial registration number NCT00552604.
And CBSNEWS report on this;
And CBSNEWS report on this;
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