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 Δ⁹-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.