Spasticity scale test not enough to show Sativex benefits

A new study from Italy has found that Sativex, a type of medical cannabis licensed in the UK for some symptoms of multiple sclerosis MS, eases symptoms related to spasticity, even in those with no significant improvements in a validated spasticity scale.

Previous studies have suggested that spasticity scales might not be enough to measure a patient’s response to Sativex or reflect the true benefit to the person.

Spasticity is a common problem in MS and can cause the muscles to feel heavy and stiff, making movement difficult. It can be associated with other symptoms such as nocturnal cramps and spasms, jerking movements, sleep disorders, pain, and bladder problems.

Studies have found evidence that the severity of spasticity directly correlates with people’s wellbeing and overall quality of life. Anti-spasticity medications are available but many people are resistant to them.

At the moment Sativex is approved for use as an add-on therapy for moderate-to-severe spasticity, but only in those resistant to first-line treatment. Evidence is increasing that Sativex, which is taken as a mouth spray, offers benefits beyond spasticity. But currently, if patients don’t show at least a 20 per cent increase in the 0-10 spasticity numerical rating scale (NRS) after a month’s trial, they are not allowed to continue the treatment and are classed as non-responders.

The Italian researchers said their study confirmed the therapeutic benefits of cannabinoids may extend beyond spasticity, and improve spasticity-related symptoms even when there was no improvement in the NRS figure. They said this evidence highlights the inability of NRS to catch all the facets of MS spasticity.

Future controlled studies are needed to confirm these potential benefits in patients considered to be unresponsive to Sativex, based on changes in a spasticity scale.