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GRADE
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69 Zitate
Stichproben = 20 Pat.
Dauer4 Wochen
EndpunktVAS
Verblindungoffen
DesignRCT (open-label)
Cannabinoidkombination
THC:CBD1:1
Applikationoromukosal
Kernaussage
Sativex reduzierte nach 4 Wochen MS-bedingten neuropathischen Schmerz und verbesserte die Lebensqualität.
Zusammenfassung
n=20 MS-Patienten (10 mit, 10 ohne neuropathischen Schmerz), Sativex® 4 Wochen vs. Baseline; VAS-Schmerzreduktion signifikant bei Schmerzgruppe, parallele Zunahme frontozentraler γ-Band-Oszillation und Schmerz-Motor-Integration (p<0.05 für neurophysiologische Parameter).
P
PopulationMS-Patienten mit und ohne neuropathischen Schmerz, n=20 (10 mit, 10 ohne neuropathischen Schmerz)
I
InterventionSativex (THC/CBD oromukosales Spray), 4 Wochen, open-label
O
OutcomeSignifikante Reduktion des Schmerzratings und Verbesserung der Lebensqualität nach 4 Wochen; begleitet von erhöhter fronto-zentraler γ-Band-Oszillation
Vertrauen in die Evidenz
Moderat
Dritte von vier GRADE-Stufen, die Effektschätzung ist wahrscheinlich verlässlich.
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Ungenauigkeit
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Verblindung
Offen
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Abstract
<h4>Objective</h4>The aim of our study was to better investigate the role of Sativex(®) in improving pain in multiple sclerosis (MS) patients by means of either clinical or neurophysiological assessment.<h4>Setting</h4>Pain is a common symptom of MS, affecting up to 70% of patients. Pain treatment is often unsatisfactory, although emerging drugs (including cannabinoids) are giving encouraging results. Clinical pain assessment in MS is very difficult, and more objective tools are necessary to better quantify this symptom and its potential response to the treatments.<h4>Subjects and methods</h4>We enrolled 20 MS patients (10 with and 10 without neuropathic pain), who underwent a specific clinical (such as visual analog scale) and neurophysiological assessment (by means of laser-evoked potentials and transcranial magnetic stimulation), before and after 4 weeks of Sativex administration.<h4>Results</h4>One month of drug administration in MS patients with neuropathic pain successfully reduced pain rating and improved quality of life. Interestingly, such effects were paralleled by an increase of fronto-central γ-band oscillation and of pain-motor integration strength.<h4>Conclusions</h4>Our data suggest that Sativex may be effective in improving MS-related neuropathic pain, maybe through its action on specific cortical pathways.
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