Indication for cannabinoids in multiple sclerosis when treatments for spasticity not effective

This review found that nabiximols (Sativex; as add‐on therapy to anti‐spasticity medications) probably reduces spasticity severity as perceived by patients at time points up to 14 weeks (moderate‐quality evidence). Nabiximols probably increases the number of people reporting a clinically important reduction in perceived severity of spasticity, and leads to improved average spasticity scores, when compared with placebo.

There was low‐certainty evidence that nabiximols, Cannabis extract or synthetic tetrahydrocannabinol (THC) cannabinoids were more effective than placebo for chronic neuropathic pain relief at time points up to 16 weeks.

For the outcome of Patient Global Impression of Change (PGIC), the review found moderate‐certainty evidence for the benefit of nabiximols, Cannabis extract or synthetic THC cannabinoids over placebo. There was evidence that cannabinoids were likely to increase the number of participants reporting “much” or “very much” improvement in the PGIC at time points up to 48 weeks.

The effect of cannabinoids on health‐related quality of life at time points up to 16 weeks was uncertain (very-low‐certainty evidence).