A draft guidance issued by the National Institute for Health and Care Excellence (NICE), a U.K. advisory board, and a review by England’s National Health Service (NHS) call for more research into medical cannabis for multiple sclerosis and other conditions.
The board’s fast-tracked guidance on cannabis-based medicinal products, open for public consultation until Sept. 5 and set to be published on Nov. 4, follows last year’s re-classification of these products to enable their use by patients whose clinical needs cannot be met by approved medications.
The assessment looked at the clinical- and cost-effectiveness of most cannabis-based products, including Sativex (by GW Pharmaceuticals). Therapies for intractable nausea and vomiting due to chemotherapy, chronic pain, and treatment-resistant severe epilepsy were also considered.
Eight separate recommendations for further research were made across all indications and products covered, which NICE said reflected an overall lack of evidence of clinical benefit and cost-effectiveness regarding these products.
Sativex is not recommended to treat MS spasticity as it was found not to be cost-effective at its current list price in the country. The guidance also recommends against using other options for the same purpose outside of a clinical trial because of “a lack of clear evidence that these treatments provide any benefits,” NICE states in its press release.
Due to limited benefits relative to high costs, no cannabis-based products should be used to treat chronic pain other than a plant-derived cannabidiol in a clinical trial setting, it adds. However, the synthetic cannabinoid nabilone can be used as an add-on therapy for adults with chemotherapy-induced nausea and vomiting who failed to respond to conventional medicines.
No recommendations were made relative to the use of cannabis-based medicines for severe treatment-resistant epilepsy, again because evidence of clear benefits is lacking.
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