Cannabis Discontinuation

Fernández Ó.THC:CBD in Daily Practice: Available Data from UK, Germany and Spain Eur Neurol. 2016;75 Suppl 1:1-3.

BACKGROUND:From the time Sativex (THC:CBD) oromucosal spray first became available in European Union countries in 2010 for the management of treatment-resistant multiple sclerosis (MS) spasticity, data from daily practice have been collected through various projects.
METHODS:A retrospective registry study and a prospective safety study of THC:CBD oromucosal spray are reported.
RESULTS:The most recent analysis of a retrospective registry established in the United Kingdom (UK), Germany and Switzerland, which collected safety data on more than 900 patients, has indicated a positive risk-benefit profile for THC:CBD oromucosal spray during long-term use. Long-term continuation rates were 68% (mean follow-up time 1 year) and the mean dose was 5.4 sprays/day. No new safety concerns were identified, and adverse events of special interest for a cannabis-based medicine were limited. The UK registry has since been closed but remains open in Germany and Switzerland. A prospective safety study undertaken in Spain involved 207 patients from 13 specialized MS centres who had been prescribed THC:CBD oromucosal spray. The findings aligned closely with the UK/German/Swiss registry data in terms of 1-year continuation rates (64.7%), mean daily dose (6.6 sprays/day) and safety profile, including no evidence of addiction, abuse or misuse.
CONCLUSIONS:The homogeneity between these observational studies supports the interest in THC:CBD oromucosal spray for management of MS spasticity in daily practice.
This study looks at the rate of continuing to take cannabis and there is about 30% discountinuation rate. This may be because of lack of efficacy or something unwantef such as side effects or perhaps the method of deliver is unpleasant. Sativex is essentiially cannbis in creme de menthe (mint tasting alcohol).

CoI We are developing alternatives and if you live in the London area and now Liverpool (Walton Centre) you could volunteer.

https://clinicaltrials.gov/ct2/show/NCT02542787

Ages Eligible for Study:  18 Years to 70 Years
Genders Eligible for Study:  Both
Accepts Healthy Volunteers:  No
Criteria
Inclusion Criteria:
  • Have a confirmed diagnosis of MS
  • Have an Expanded Disability Status Scale (EDSS) ≤ than 6.5 at screening.
  • Spasticity due to MS of at least 3 months duration with minimum mean score of >/=2 m ASHWORTH SCORE
Exclusion Criteria:
  • Acute MS relapse requiring treatment with steroids within 30 days of screening.
  • Initiation or discontinuation of MS disease modifying treatment (DMT) within 30 days of screening.
  • Receiving medications that would potentially interfere with the actions of the study medication or outcome variables
  • Significant renal and hepatic abnormalities
  • Previous history of other significant medical disorders

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