Cannabinoids do not reduce objective measurements in muscle spasticity, but people with multiple sclerosis perceive some benefit

Abstract

Question Do cannabinoids have a beneficial effect on muscle spasticity and other symptoms associated with multiple sclerosis? Study Design Double-blind randomised placebo controlled trial. Main Results At 15 weeks, neither cannabis extract nor Δ 9-tetrahydrocannabinol (THC) reduced muscle spasticity, compared with placebo (mean difference in Ashworth score: cannabis extract vs. placebo 0.32, 95% CI −1.04 to 1.67; THC vs. placebo 0.94, 95% CI −0.44 to 2.31). Participants taking cannabinoids reported improvements in mobility, pain, sleep quality, spasms and spasticity, but not irritability, depression, tiredness, tremor or energy (see Table 1). Table 1 Results of primary and secondary outcomes. Cannabis extract THC Placebo P value (baseline to follow-up) Primary and objective outcomes Mean change from baseline in Ashworth scores 1.24 1.86 0.92 0.4 Reduction in median time taken to walk 10 m (95% CI) 4% (0 to 10) 12% (6 to 21) 4% (−2 to 7) 0.015 Secondary, subjective outcomes: percentage of participants whose symptoms improved relative to baseline Pain 46% 50% 30% 0.002 Spasticity 52% 51% 37% 0.010 Spasms 53% 49% 39% 0.038 Sleep 50% 47% 36% 0.025 Tiredness 28% 22% 22% 0.068 Shake/tremor 38% 41% 33% 0.398 Energy 33% 35% 24% 0.140 Irritability 39% 33% 26% 0.619 Depression 36% 29% 28% 0.298 Authors’ Conclusions Although cannabinoids are not beneficial for treating spasticity measured by the Ashworth score, they are useful for treating other symptoms of multiple sclerosis.