The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.


PHILADELPHIA — Real-life outcomes support the long-term effectiveness of tetrahydrocannabinol and cannabidiol (THC:CBD) to improve spasticity in patients with multiple sclerosis (MS) resistant to other medications. This research was presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, in Philadelphia.

The investigators of this observational, prospective, multicenter study sought to evaluate real-life, long-term efficacy outcomes of THC:CBD oromucosal spray to treat a large population of Italian patients with treatment-resistant MS spasticity. Spasticity was assessed using a numerical rating scale (0-10) at baseline, 1 month, 6 months, 12 months, and 18 months after treatment initiation.

After one month, 1502 (81.4%) of 1845 patients achieved ≥20% improvement in numerical rating scale for spasticity and 814 (40.2%) achieved ≥30% improvement. The mean reduction in spasticity scores was 28.9% at month 1 and 36.8% at month 18. A total of 727 (39.4%) participants discontinued treatment: 388 reported a lack of effectiveness whereas 339 experienced adverse events. The most frequently reported adverse events were vertigo (37.5%), sleepiness (34.8%), worsening of fatigue (28.3%), and cognitive symptoms (15.9%). In multivariate analysis, patients with a higher baseline spasticity score (odds ratio 2.21; 95% CI, 1.12-6.28; P <.01) or a greater change in scores between baseline and month 1 (odds ratio 2.03; 95% CI, 1.04-8.14; P <.05) were twice as likely to maintain therapy beyond 18 months.

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The investigators suggest these results confirm the effectiveness of THC:CBD therapy to reduce treatment-resistant MS spasticity and sustain improvement for 18 months.

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Reference

Patti F, Chisari C, D’Amico E, et al. Long-term effectiveness of 9-δ-tetrahydrocannabinol:cannabidiol oromucosal spray in clinical practice: results from a 18-months multicenter Italian study. Poster presented at: 2019 American Academy of Neurology Annual Meeting; May 9, 2019; Philadelphia, PA.