Effective treatments are limited for both symptom relief and for slowing/halting the progression of the condition.
However, there is hope with medical use of marijuana, with the evidence behind using cannabinoids for symptom relief being quite strong now. This new study, called the MUSEC study, is more evidence supporting that view--and likely one of the strongest studies to date.
279 patients with stable MS at 22 centres in the UK were randomised to receive either an oral cannabis extract (CE) or placebo. This double blind, placebo controlled, phase III study had a screening period, a 2-week dose titration phase of increasing amounts of tetrahydrocannabinol (THC), and a 10-week maintenance phase. The primary endpoints measured were a category rating scale (CRS) measuring patient-reported change in muscle stiffness from baseline. Further CRSs assessed body pain, spasms and sleep quality. Three validated MS-specific patient reported outcome measures assessed aspects of spasticity, physical and psychological impact, and walking ability.
Results showed that the rate of relief from muscle stiffness after 12 weeks was almost twice as high with CE than with placebo (similar results were also seen at 4 and 8 weeks), and also for all further CRSs. Results from the three MS scales supported these findings.
Adverse effects in the CE group were consistent with the known psychotropic side effects of cannabinoids. No new safety concerns were observed
While this study only showed MS symptom relief, the lead researcher is convinced that drugs containing THC can work to alter (slow/halt) the progression of MS. He believes future studies will bear this out.
"There are multiple theoretical reasons for why this kind of drug should help," he said. "Firstly, it's anti-apoptotic, so it prevents cell death. Secondly, it reduces the release of excitatory neurotransmitters, so it reduces glutamate release, which is implicated with cell death in nerve cells. Thirdly, it's an antioxidant, so it reduces free radical damage. Then there are other theoretical reasons why it might be helpful, for example, it might interfere with protein folding, it has anti-inflammatory action, and it reduces migration of inflammatory cells."
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Source: MUltiple Sclerosis and Extract of Cannabis: results of the MUSEC trial
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