Category Archives: Multiple Sclerosis (MS)

Advances in the Management of MS Spasticity: Recent Observational Studies.

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“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.

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.

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.

Observational data and real world experience reinforce the efficacy and safety of THC:CBD oromucosal spray as reported in phase III clinical trials.”

http://www.ncbi.nlm.nih.gov/pubmed/25278118

http://www.thctotalhealthcare.com/category/multiple-sclerosis-ms/

Advances in the management of multiple sclerosis spasticity: recent clinical trials.

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“Most patients with multiple sclerosis (MS) experience spasticity as the clinical course evolves. Associated symptoms include (often painful) spasms, urinary dysfunction and sleep disturbances. THC:CBD oromucosal spray (Sativex®) is approved for symptom improvement in adult patients with moderate to severe MS-related spasticity who have not responded adequately to other antispasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy.

SUMMARY:

In pivotal clinical trials of THC:CBD oromucosal spray, a meaningful proportion of patients with treatment-resistant MS spasticity achieved clinically relevant improvement with active treatment versus placebo. The utility of a 4-week trial of therapy to identify patients who respond to treatment was demonstrated in an enriched-design study.

THC:CBD oromucosal spray was well tolerated in these studies, with no evidence of effects typically associated with recreational cannabis use.

In a subsequent post approval clinical trial, THC:CBD oromucosal spray had no statistically significant effect on cognition and mood compared with placebo.

Moreover, after 50 weeks’ treatment, approximately two-thirds of patients, physicians and caregivers reported improvement from baseline in spasticity based on global impressions of change.

In phase III clinical trials, approximately one-third of MS patients with treatment-resistant spasticity had a clinically relevant and statistically significant response to THC:CBD oromucosal spray.

In addition to a reduction in spasticity, responders experienced meaningful relief from associated symptoms.

THC:CBD oromucosal spray was generally well tolerated and efficacy was maintained over the longer term.

A post-approval clinical trial indicated no effect of THC:CBD oromucosal spray on cognition or mood after 50 weeks of use.”

http://www.ncbi.nlm.nih.gov/pubmed/25278117

http://www.thctotalhealthcare.com/category/multiple-sclerosis-ms/

Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity nervous pathways.

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“Involvement of the endocannabinoid system in pathophysiological mechanisms responsible for spasticity has been demonstrated in animal models of MS…

Evidence indicates that the antispasticity effects of THC:CBD oromucosal spray (Sativex®) are associated with enhanced cortical long-term potentiation.

CB1 receptors, which are associated with movement, postural control, and pain and sensory perception, influence glutamatergic pathways.

THC:CBD oromucosal spray was shown to reverse motor cortex plasticity from long-term depression through long-term potentiation of synaptic transmission, thereby restoring, at least in part, effective corticospinal inputs to spinal circuits.”

http://www.ncbi.nlm.nih.gov/pubmed/25278116

http://www.thctotalhealthcare.com/category/multiple-sclerosis-ms/

Drug-resistant MS spasticity treatment with Sativex® add-on and driving ability.

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“The aim of the present observational study was to determine the effects of a delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) oromucosal spray (Sativex® spray), brand name Sativex® , indicated for drug-resistant MS spasticity, on the driving ability of treated MS patients…

Treatment of MS patients with Sativex® does not negatively impact on driving ability and may improve moderate to severe treatment-resistant MS spasticity.”

http://www.ncbi.nlm.nih.gov/pubmed/25208898

Delta-9-tetrahydrocannabinol + cannabidiol. A reasonable option for some patients with multiple sclerosis.

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“Conventional drugs have only a limited impact on spasticity associated with multiple sclerosis and are rarely satisfactory. A solution for oral transmucosal delivery (spray) containing a mixture of cannabis extracts (2.7 mg of delta-9-tetrahydrocannabinol + 2.5 mg of cannabidiol per spray) has been granted marketing authorisation in France for patients who are inadequately relieved by standard treatments. Three double-blind, placebo-controlled trials in a total of about 300 patients tested this combination, in addition to ongoing treatment, for periods of 6 to 14 weeks. Individually, none of these trials showed any tangible anti-spastic efficacy, but two combined analyses showed “response rates” of about 35% with the mixture versus about 25% with placebo. In a trial with 572 patients, the 241 patients who “responded” after 4 weeks of treatment were randomised to either continue using the cannabis extract or receive placebo. Twelve weeks later, 75% of patients using the extract were still “responders”, versus 51% of patients switched to placebo. The principal adverse effects of the cannabis extracts consist of neuropsychiatric disorders that resolve on treatment withdrawal. The potential for abuse increases with the dose and is tangible from 16 sprays per day. Pharmacokinetic interactions due to P-glycoprotein inhibition are likely. Treatment during pregnancy may lead to neonatal withdrawal symptoms. In practice, about 10% of patients in whom standard anti-spastic medications are unsatisfactory benefit from a specific effect of the cannabis extracts contained in this oral spray.”

http://www.ncbi.nlm.nih.gov/pubmed/25121144

Current and future drugs for treatment of MS-associated bladder dysfunction.

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“A majority of patients diagnosed with multiple sclerosis (MS) will develop lower urinary tract symptoms (LUTS) during the course of the disease…

Cannabis extracts have shown some promise but has still not gained wide acceptance…

http://www.ncbi.nlm.nih.gov/pubmed/24954496

http://www.thctotalhealthcare.com/category/multiple-sclerosis-ms/

Smoking Marijuana Relieves Symptoms of Multiple Sclerosis in Patients, with Minor Cognitive Effects

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marijuana

“Smoking marijuana has been shown to relieve muscle tightness, called spasticity, and painful symptoms in patients with multiple sclerosis, who have been resistant to conventional MS therapies, according to a new study.

“We found that smoked cannabis was superior to placebo in reducing symptoms and pain in patients with treatment-resistant spasticity, or excessive muscle contractions,” Researcher Dr. Jody Corey-Bloom, director of the University of California, San Diego Multiple Sclerosis Center said in a journal news release.”

http://www.medicaldaily.com/smoking-marijuana-relieves-symptoms-multiple-sclerosis-patients-minor-cognitive-effects-240433

“Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394820/

http://www.thctotalhealthcare.com/category/multiple-sclerosis-ms/

Marijuana Helps Relieve MS Pain

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“Researchers from the University of California, San Diego School of Medicine have found that smoking marijuana can help relieve pain, and muscle tightness “spasticity” in individuals with multiple sclerosis (MS). The study is published in the Canadian Medical Association Journal (CMAJ).”

http://www.medicalnewstoday.com/articles/245430.php

“Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394820/

Marijuana can treat autoimmune diseases, scientific study states

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“Weed enthusiasts are getting their case for nationwide decriminalization of marijuana bolstered considerably by a new scientific study that promises the controversial plant can treat multiple medical maladies.

Scientists at the University of South Carolina have discovered marijuana’s potential to treat autoimmune diseases — such as arthritis, lupus, colitis and multiple sclerosis — in which chronic inflammation plays a pivotal role.

The Journal of Biological Chemistry published the researchers’ findings that state marijuana’s potential key role in fighting these diseases lies in its capacity to suppress certain immune functions, most particularly inflammation.

The study examined whether marijuana’s main active constituent, tetrahydrocannabinol (THC), could affect DNA through “epigenetic” pathways.

The group of molecules with the capacity to alter DNA and the functioning of genes it controls is collectively referred to as the epigenome. It includes a group of molecules called histones, which are responsible for inflammation, both beneficial and harmful.

The research team, led by Mitzi Nagarkatti, Prakash Nagarkatti and Xiaoming Yang, found that THC can, indeed, affect DNA expression through epigenetic pathways by altering histones.

As recreational and medical use of marijuana become more acceptable in developed countries, more research is being conducted and more potential health applications are being uncovered.

Marijuana already has a variety of medical uses including treatment of chronic pain, nausea, vomiting and the wasting syndrome experienced by some AIDS patients.”

http://atlantadailyworld.com/2014/06/05/marijuana-can-treat-autoimmune-diseases-scientific-study-states/

Marijuana could treat autoimmune diseases: study

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“The drug has potential to work on chronic inflammation, found in disease like arthritis, lupus, colitis and MS. It may work by suppressing immune functions.

 New findings suggest marijuana’s potential key role in fighting autoimmune diseases lies in its capacity to suppress certain immune functions, notably inflammation.

Building the case for the most widely used illicit drug in developed countries, researchers from the University of South Carolina have discovered marijuana’s potential to treat autoimmune diseases in which chronic inflammation plays a pivotal role.”

http://www.nydailynews.com/life-style/health/marijuana-treat-autoimmune-diseases-study-article-1.1816609