Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial
Jody Corey-Bloom, MD PhD⇓, Tanya Wolfson, MA, Anthony Gamst, PhD, Shelia Jin, MD MPH, Thomas D. Marcotte, PhD, Heather Bentley, BA, Ben Gouaux, BA
From the Departments of Neurosciences (Corey-Bloom), Biostatistics (Wolfson, Gamst, Jin) and Psychiatry (Marcotte, Bentley); and the Center for Medicinal Cannabis Research (Marcotte, Bentley, Gouaux), University of California, San Diego, La Jolla, Calif.
Background:Spasticity is a common and poorly controlled symptom of multiple sclerosis. Our objective was to determine the short-term effect of smoked cannabis on this symptom.
Methods:We conducted a placebo-controlled, crossover trial involving adult patients with multiple sclerosis and spasticity. We recruited participants from a regional clinic or by referral from specialists. We randomly assigned participants to either the intervention (smoked cannabis, once daily for three days) or control (identical placebo cigarettes, once daily for three days). Each participant was assessed daily before and after treatment. After a washout interval of 11 days, participants crossed over to the opposite group. Our primary outcome was change in spasticity as measured by patient score on the modified Ashworth scale. Our secondary outcomes included patients’ perception of pain (as measured using a visual analogue scale), a timed walk and changes in cognitive function (as measured by patient performance on the Paced Auditory Serial Addition Test), in addition to ratings of fatigue.
Results:Thirty-seven participants were randomized at the start of the study, 30 of whom completed the trial. Treatment with smoked cannabis resulted in a reduction in patient scores on the modified Ashworth scale by an average of 2.74 points more than placebo (p < 0.0001). In addition, treatment reduced pain scores >Interpretation: Smoked cannabis was superior to placebo in symptom and pain reduction in participants with treatment-resistant spasticity. Future studies should examine whether different doses can result in similar beneficial effects with less cognitive impact.
Article Courtesy of: http://www.cmaj.ca/content/184/10/1143.abstract
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