Sativex Study Reports Positive Results in People With MS
Could a cannabis spray be just what the doctor ordered to treat our MS symptoms? I’m talking about Sativex (nabiximols), which has been developed as a treatment for moderate and severe MS spasticity.
Sativex combines THC, the chef intoxicant in marijuana, with CBD, marijuana’s nonpsychoactive component. It’s sprayed under the tongue or inside the cheek several times a day. The treatment has been approved in several countries, including the U.K. and Canada, but in the U.S., it’s still considered to be investigational. A Phase 3 trial is underway.
Brussels study reports positive results
A small study in Belgium, published in BMC Neurology in late June, contains encouraging news about Sativex for people with MS. A group of 238 people with MS used the treatment several times a day for 12 weeks. During the study, two tests were given: the Numerical Rating Scale (NRS), which measures pain (with a 10 being the worst), and the EuroQoL Visual Analogue Scale (EQ VAS), a self-assessed quality of life rating (with 100 being the best).
NRS scores improved from 8.1 at baseline to 5.2 at week four, 4.6 at week eight, and 4.1 at week 12. EQ VAS scores increased from 39 at baseline to 52 at week four, 57 at week eight, and 59 at week 12. Scores on both tests remained at the 12-week level in some smaller groups whose participants continued to be tested for as long as 12 months.
The authors of this study conclude that, “More than 60% of the patients with MS who started add-on treatment with cannabinoid oromucosal spray reported a clinically relevant symptomatic effect and continued treatment after 12 weeks.”
A friend tells me about his Sativex experience
About the same time the BMC Neurology report was being published, I heard from Daniel Verbeke, a reader of my column who lives in Belgium. Daniel has been using Sativex since last January and reports mixed results.
In an email, he wrote that by starting at one spray a day and building up to eight, he saw “no spectacular improvements.” But the spasticity in his right leg decreased, and he said he was “in a much better mood” to walk with a walking stick, when previously he would often use a wheelchair or scooter.
Daniel told me he felt none of the “high” associated with marijuana and had no side effects, such as a headache or dizziness.
“It’s not that much, but enough for me to continue the therapy,” he wrote.
Daniel told me that in Belgium, the price of three Sativex bottles is 24 euros ($28.50) with a prescription. Without one, the price jumps to 922 euros ($1,093.22). Wow!
I wonder how many people will think the results are worth the cost, and whether, if approved in the U.S., insurance will cover it.
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Comments
Elizabeth Williams
It sounds like it's at least worth a try, but I wonder about one thing. I tried small doses of cannabis at night a few months ago (I live in Massachusetts, so it was legal, even without a prescription). It helped with muscle cramps, I slept like a rock, and I didn't feel at all high. The problem was that the next day, I had a hard time concentrating on work. Does Sativex cause even mild mental impairment?
Ed Tobias
I don't know, Elizabeth. However, my friend in Belgium told me he had no high and no side-effects. I guess we'd need to see what the clinical trials report and, hopefully, we'll have that info by the end of the year.
Ed
Dorothy Levinson
Why are we always the LAST country to get new ttreatments for our citizens. And the treatments cost much more here, too. We used to be first in everything but not now. How sad.
Jane
This is great news! Question: Is Sativex synthetic? With the side effects of other medications for MS, and if Sativex is naturally produced, it would definitely be worth a try.
Insurance coverage in the US is another thing altogether - most do not cover alternative therapies known to produce positive effects, such as massage therapy and acupuncture. It saddens me to say that I don't expect any exception for this valuable addition to pain management - until and unless the powers that be get involved. Hopefully they will get involved because this is most probably a game changer for many issues people with MS have to deal with.
Ed Tobias
Hi Jane,
I don't know the pharmacology of Sativex. Howwever, GW Pharmaceuticals says it's intended for use with other anti-spasticity medications. The company intends to apply for FDA approval of Sativex, so I don't think it would be considered an alternative therapy. Fingers crossed on insurance.
Ed
Brian O’Neill
Sounds promising. When will trial #3 be over? I hope insurance covers it. Thanks.
Ed Tobias
Hi Brian,
GW Pharmaceuticals has two trials underway in the U.S. and is planning three more. All are studying the effect of Sativex on MS spasticity. A news release from the company says it hopes to have results from one of the studies before the end of this year.
I also hope insurance will cover it, if it gets approved.
Ed
Maree Foxcroft
Was wandering if this wld b suitable for my PPMS
Ed Tobias
That's hard to say, Maree. It probably would be but think we'll need to wait until the clinical trials end to really know.
Ed
Kathy B
I began taking THC gummies last year (2020). They were wonderful. I took one every night at bedtime. I was able to sleep so well and noticed less rigidity in my legs. Unfortunately, I had a blood test last November for my MS and my leukocyte count was abnormally low. THC can reduce your leukocytes. Thus, I had to stop. It was a letdown, for sure.
Ed Tobias
Hi Kathy,
Thanks for sharing. I didn't know that about THC so I'll have to do some reading and educate myself. Sorry you had to stop.
Ed
SUSAN Ratcliffe
Hopes are continually frustrated by tight-fisted CCG's. Decisions as to which MS patients can benefit from a Sativex prescription still appears to be a postcode lottery.
David lawrence Kirchner
You gave the cost of a bottle, no clue as to how long a battle lasts, 1hour? 1 day? 1 week? what?
Ed Tobias
Davie,
You're right. I dropped the ball on that. I'll find out and get back to you.
Ed
Ed Tobias
David,
First, apologies for the typo in spelling your name when I first responded. I've checked with Daniel and he says, at six sprays a day a bottle lasts five to six weeks.
Ed
Anthony Hoysted
Sativex is also approved in Australia for MS spasticity. To the best of my knowledge, it is an extract derived from naturally-grown cannabis plants. Its composition and the proportion of CBD and THC are carefully controlled.
However, in Australia, only a specialist neurologist can prescribe Sativex. It must be given a four-week trial, and other muscle relaxants must have been tried and found ineffective. More importantly, the cost is not subsidised by the Australian government (most medications are), and comes to around US$560 for 6-8 weeks' supply. I think this would mean that few people in Australia are trying it at present (if the person has private health insurance, it will cover some but not all of the cost of a year's supply). If at any time Sativex becomes subsidised under the Australian Pharmaceutical Benefits Scheme, the cost will come down to around US$30 per month or US$5 per month for low income earners, at which point I imagine many people with MS would try it.
Ed Tobias
Hi Anthony,
Thanks for sharing that great information. It's a shame that the national health service isn't supporting Sativex. I fear that the same will be true here in the U.S., even if our Food and Drug Administration okays its use for MS. I suspect you're correct when you assume people are probably not even trying it due to the expense. I hope we can pressure our decision-makers to put Sativex onto the list of the meds for which they will pay.
Ed
Allan Kyte
I am writing on behalf of my wife ,who is sadly a quadriplegic M.S sufferer . Fiona ,was a pioneer with regard to the use of Sativex ,some fifteen-twenty years ago ,having been a trialist for this product . In those days it was in tablet form ,which sadly settled in her stomach , made her anorexic ,and losing three stone ,in three months and being taken off it ,with some urgency.
Once it became available in spray form however ,she went back on the trials and has remained so ever since, with no ill effects what so ever and for anyone thinking about requesting it "DO SO ,WITHOUT HESITATION " as ,in our opinion after many years of constant use ,it has proven to be "THE BEST PAIN RELIEF,KNOWN TO MANKIND "Easy and quick to take and quick to take effect (providing that you stick to the recommended dosage) and quite
quickly eases ,what in her case are agonising spasms ,(particularly in her neck" which makes her scream aloud
Yours sincerely
Allan Kyte
( On behalf of Mrs. Fiona Kyte)n
Ed Tobias
Hello Allan,
Thanks very much for taking the time to share your wife's experience. It's wonderful that she's done so well with the Sativex spray. I know others who read what you wrote will be very grateful for that information.
My best wishes to Mrs.Kyte,
Ed
DJ
Hi Ed,
here's my report about it, being a male with PPMS diagnosed about a year ago.
My neurologist gave prescribed it to me for a "try" and after several days I can report absolutely no effect. I do have previous youth experience in cannabis so maybe this has effect only on those who never smoked it, I can't tell. In addition, the aftertaste is just horrendous! Who designed this to spray it 12x a day directly into your mouth?! Makes me want to vomit on 5th application. Very repulsive.
On another note, can you explore possibility to add "night mode" to your site? White background puts enormous strain on my eyes and inverted works great but i can't use high contrast scheme most of the time as I'm an IT professional where most of healthy do not really care about those like me with optical nerve sensitivity while doing design of their websites and where most IT tools are not optimized for it.
Thanks!
Olivier Fouques
I personally take cannabis infused chocolate regularly. Each chocolate contains 5mg of THC and my last blood test didn't show anything abnormal.
That is a good thing about living in California. ;-)
Ed Tobias
Thanks for the info, Olivier. Is what you're taking 100% THC or is it a THC/CBD blend?
Ed
Mary Whiteley
I have had very painful and disabling spasticity since 2010 and have tried every anti-spasmodic offered to no effect. I was eligible for a month's free trial of Sativex via the NHS from February 2020 but due to Covid only trying it in April 2021. I personally experienced fantastic improvements. I had to wait for my local Care Commission group to approve my prescription and received my first prescription in November. My legs now have normal tone, are no longer painful and feel like they have defrosted. I don't have any side effects- it doesn't taste great-but it is a very small price to pay. I would highly recommend trying it if offered.
Ed Tobias
Hi Mary -
That's great news. Thanks for sharing. I'd really like to try Sativex and hope that it becomes available in the U.S. soon.
Ed