In MS, Medicinal Cannabinoids Are Still Controversial

A recent systematic review and meta-analysis of 17 randomized clinical trials has revealed that medicinal cannabinoids have limited positive effects for the treatment of spasticity, pain, and bladder dysfunction in patients with multiple sclerosis (MS). At the same time, the researchers found that medicinal cannabinoid-based therapy can be considered safe.¹

The researchers looked at self-reported data from 3161 patients.

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Cannabinoid use yielded limited but statistically significant differences when compared with the efficacy of placebo. However, the mild reduction patients reported has uncertain clinical significance to the 3 symptoms of spasticity, pain, and bladder dysfunction.

And while the data showed that cannabinoids are associated with more adverse effects such as vertigo, dry mouth, and fatigue, as well as more study withdrawals due to those adverse effects, the researchers found no statistically significant difference in the occurrence of serious adverse effects.

“Given the relative safety of these agents, lack of strong evidence of other effective treatment options, and increasing access in some jurisdictions, it may seem appealing to include cannabinoids in the armamentarium of therapies for MS,” wrote Marissa Slaven, MD, of Hamilton, Ontario’s Juravinski Cancer Centre in the study’s commentary. “But carefully conducted, high-quality studies with thought given to the biologic activity of different cannabis components are still required to inform on the benefits of cannabinoids for patients with MS.”²

“To our knowledge, this is the most complete systematic review and meta-analysis of the effect of cannabinoids on MS,” the study authors wrote. “Clear methodological differences exist among our systematic review and the ones published so far. The standardization conducted in our study allows comparison among different types of results that cannot be reliably compared otherwise.”¹ 

–Colleen Murphy

References:

1. Torres-Moreno M, Papaseit E, Torrens M, Farreé M. Assessment of efficacy and tolerability of medicinal cannabinoids in patients with multiple sclerosis: a systematic review and meta-analysis [published online October 12, 2018]. JAMA Network Open. doi:10.1001/jamanetworkopen.2018.3485.
2. Slaven M. Cannabinoids for symptoms of multiple sclerosis benefits to patients still unclear [published online October 12, 2018]. JAMA Network Open. doi:10.1001/jamanetworkopen.2018.3484.