Multiple sclerosis spasticity symptoms management. Endocannabinoid system modulator data beyond clinical trials

Multiple sclerosis (MS) is a progressive disease that is both disabling and highly symptomatic. Spasticity is one of the more common MS symptoms, occurring in approximately two-thirds of patients, and it presents as increasing muscle rigidity, often with spasms and altered reflexes. Approximately a third of MS patients alter their daily activities owing to spasticity and the consequences for the individual can be far reaching in terms of reduced mobility, painful spasms, sleep disturbances and bladder dysfunction. Overall, MS spasticity has a marked negative impact on the MS patient’s wellbeing and quality of life, and usually leads to an increased need for rehabilitation and supportive nursing care. Historically, a number of classic antispasticity drugs have been used to treat MS patients; however, a systematic review by the Cochrane group concluded that the benefits of such treatments were limited [1].

In recent years, research has focused on the endocannabinoid system as a feasible therapeutic target for MS spasticity, as it has been shown to be involved in the modulation of neurotransmission at both inhibitory and excitatory synapses in the CNS. In this satellite symposium, our expert speakers will review recent findings relating to the epidemiology and impact of spasticity in the MS community, before examining the clinical evidence available for Sativex^® (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain), a first-in-class endocannabinoid system modulator, whose main active ingredients are the cannabinoids 9-δ-tetrahydrocannabinol and cannabidiol. Sativex is available as an oromucosal spray and has produced positive results in pivotal Phase III clinical trials, being approved by numerous health authorities worldwide as an add-on therapy for individuals with resistant MS-related spasticity. In this symposium, data from everyday clinical practice, including German observational studies and recent findings from the UK and Spanish registries, will be presented to augment our understanding of the clinical attributes of Sativex in patients with this difficult-to-treat and highly debilitating disease.

Financial & competing interests disclosure

M Trojano received an honorarium from Laboratorios Almirall, SA (Barcelona, Spain) for her participation in the symposium and for producing this supplement article. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was provided by Content Ed Net, with funding from Laboratorios Almirall, SA.