Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity

F. Patti, S. Messina, C. Solaro, M.P. Amato, R. Bergamaschi, S. Bonavita, R. Bruno Bossio, V. Brescia Morra, G.F. Costantino, P. Cavalla, D. Centonze, Giancarlo Comi, S. Cottone, M. Danni, A. Francia, A. Gajofatto, C. Gasperini, A. Ghezzi, A. Iudice, G. LusG.T. Maniscalco, M.G. Marrosu, M. Matta, M. Mirabella, E. Montanari, C. Pozzilli, M. Rovaris, E. Sessa, D. Spitaleri, M. Trojano, P. Valentino, M. Zappia

Research output: Contribution to journalArticle

Abstract

Background The approval of 9-δ-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex) for the management of treatment-resistant multiple sclerosis (MS) spasticity opened a new opportunity for many patients. The aim of our study was to describe Sativex effectiveness and adverse events profile in a large population of Italian patients with MS in the daily practice setting. Methods We collected data of all patients starting Sativex between January 2014 and February 2015 from the mandatory Italian medicines agency (AIFA) e-registry. Spasticity assessment by the 0-10 numerical rating scale (NRS) scale is available at baseline, after 1month of treatment (trial period), and at 3 and 6months. Results A total of 1615 patients were recruited from 30 MS centres across Italy. After one treatment month (trial period), we found 70.5% of patients reaching a ≥20% improvement (initial response, IR) and 28.2% who had already reached a ≥30% improvement (clinically relevant response, CRR), with a mean NRS score reduction of 22.6% (from 7.5 to 5.8). After a multivariate analysis, we found an increased probability to reach IR at the first month among patients with primary and secondary progressive MS, (n=1169, OR 1.4 95% CI 1.04 to 1.9, p=0.025) and among patients with >8 NRS score at baseline (OR 1.8 95% CI 1.3-2.4 p
Original languageEnglish
Pages (from-to)944 - 951
Number of pages8
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume87
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

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Cannabinoids
Multiple Sclerosis
Safety
Chronic Progressive Multiple Sclerosis
Cannabidiol
Efficacy
Spray
Italy
Registries
Therapeutics
Multivariate Analysis
Population
tetrahydrocannabinol-cannabidiol combination
Rating Scales

ASJC Scopus subject areas

  • Surgery
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Psychiatry and Mental health

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Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity. / Patti, F.; Messina, S.; Solaro, C.; Amato, M.P.; Bergamaschi, R.; Bonavita, S.; Bruno Bossio, R.; Brescia Morra, V.; Costantino, G.F.; Cavalla, P.; Centonze, D.; Comi, Giancarlo; Cottone, S.; Danni, M.; Francia, A.; Gajofatto, A.; Gasperini, C.; Ghezzi, A.; Iudice, A.; Lus, G.; Maniscalco, G.T.; Marrosu, M.G.; Matta, M.; Mirabella, M.; Montanari, E.; Pozzilli, C.; Rovaris, M.; Sessa, E.; Spitaleri, D.; Trojano, M.; Valentino, P.; Zappia, M.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 87, No. 9, 01.09.2016, p. 944 - 951.

Research output: Contribution to journalArticle

Patti, F, Messina, S, Solaro, C, Amato, MP, Bergamaschi, R, Bonavita, S, Bruno Bossio, R, Brescia Morra, V, Costantino, GF, Cavalla, P, Centonze, D, Comi, G, Cottone, S, Danni, M, Francia, A, Gajofatto, A, Gasperini, C, Ghezzi, A, Iudice, A, Lus, G, Maniscalco, GT, Marrosu, MG, Matta, M, Mirabella, M, Montanari, E, Pozzilli, C, Rovaris, M, Sessa, E, Spitaleri, D, Trojano, M, Valentino, P & Zappia, M 2016, 'Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity', Journal of Neurology, Neurosurgery and Psychiatry, vol. 87, no. 9, pp. 944 - 951. https://doi.org/10.1136/jnnp-2015-312591
Patti, F. ; Messina, S. ; Solaro, C. ; Amato, M.P. ; Bergamaschi, R. ; Bonavita, S. ; Bruno Bossio, R. ; Brescia Morra, V. ; Costantino, G.F. ; Cavalla, P. ; Centonze, D. ; Comi, Giancarlo ; Cottone, S. ; Danni, M. ; Francia, A. ; Gajofatto, A. ; Gasperini, C. ; Ghezzi, A. ; Iudice, A. ; Lus, G. ; Maniscalco, G.T. ; Marrosu, M.G. ; Matta, M. ; Mirabella, M. ; Montanari, E. ; Pozzilli, C. ; Rovaris, M. ; Sessa, E. ; Spitaleri, D. ; Trojano, M. ; Valentino, P. ; Zappia, M. / Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity. In: Journal of Neurology, Neurosurgery and Psychiatry. 2016 ; Vol. 87, No. 9. pp. 944 - 951.
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abstract = "Background The approval of 9-δ-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex) for the management of treatment-resistant multiple sclerosis (MS) spasticity opened a new opportunity for many patients. The aim of our study was to describe Sativex effectiveness and adverse events profile in a large population of Italian patients with MS in the daily practice setting. Methods We collected data of all patients starting Sativex between January 2014 and February 2015 from the mandatory Italian medicines agency (AIFA) e-registry. Spasticity assessment by the 0-10 numerical rating scale (NRS) scale is available at baseline, after 1month of treatment (trial period), and at 3 and 6months. Results A total of 1615 patients were recruited from 30 MS centres across Italy. After one treatment month (trial period), we found 70.5{\%} of patients reaching a ≥20{\%} improvement (initial response, IR) and 28.2{\%} who had already reached a ≥30{\%} improvement (clinically relevant response, CRR), with a mean NRS score reduction of 22.6{\%} (from 7.5 to 5.8). After a multivariate analysis, we found an increased probability to reach IR at the first month among patients with primary and secondary progressive MS, (n=1169, OR 1.4 95{\%} CI 1.04 to 1.9, p=0.025) and among patients with >8 NRS score at baseline (OR 1.8 95{\%} CI 1.3-2.4 p",
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T1 - Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity

AU - Patti, F.

AU - Messina, S.

AU - Solaro, C.

AU - Amato, M.P.

AU - Bergamaschi, R.

AU - Bonavita, S.

AU - Bruno Bossio, R.

AU - Brescia Morra, V.

AU - Costantino, G.F.

AU - Cavalla, P.

AU - Centonze, D.

AU - Comi, Giancarlo

AU - Cottone, S.

AU - Danni, M.

AU - Francia, A.

AU - Gajofatto, A.

AU - Gasperini, C.

AU - Ghezzi, A.

AU - Iudice, A.

AU - Lus, G.

AU - Maniscalco, G.T.

AU - Marrosu, M.G.

AU - Matta, M.

AU - Mirabella, M.

AU - Montanari, E.

AU - Pozzilli, C.

AU - Rovaris, M.

AU - Sessa, E.

AU - Spitaleri, D.

AU - Trojano, M.

AU - Valentino, P.

AU - Zappia, M.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background The approval of 9-δ-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex) for the management of treatment-resistant multiple sclerosis (MS) spasticity opened a new opportunity for many patients. The aim of our study was to describe Sativex effectiveness and adverse events profile in a large population of Italian patients with MS in the daily practice setting. Methods We collected data of all patients starting Sativex between January 2014 and February 2015 from the mandatory Italian medicines agency (AIFA) e-registry. Spasticity assessment by the 0-10 numerical rating scale (NRS) scale is available at baseline, after 1month of treatment (trial period), and at 3 and 6months. Results A total of 1615 patients were recruited from 30 MS centres across Italy. After one treatment month (trial period), we found 70.5% of patients reaching a ≥20% improvement (initial response, IR) and 28.2% who had already reached a ≥30% improvement (clinically relevant response, CRR), with a mean NRS score reduction of 22.6% (from 7.5 to 5.8). After a multivariate analysis, we found an increased probability to reach IR at the first month among patients with primary and secondary progressive MS, (n=1169, OR 1.4 95% CI 1.04 to 1.9, p=0.025) and among patients with >8 NRS score at baseline (OR 1.8 95% CI 1.3-2.4 p

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