ORAL CANNABIS BENEFICIAL TO MS, STUDY SUGGESTS

However, Further Studies and More Treatment Options Are Still Needed

CALGARY - The first large-scale randomized trial to assess if cannabis
really does have potential benefit in treating multiple sclerosis
symptoms has produced mixed results.

There's some evidence that cannabis could be clinically useful in the
treatment of symptoms related to MS, but more work is necessary using
outcome measures that more adequately assess the effect of symptoms in
chronic disease, concluded principal investigator Dr. John Zajicek, a
neurologist at Peninsula Medical School in Plymouth, England.

In a study published in the Lancet, 630 patients with stable MS and
muscle spasticity were treated at 33 centres for 15 weeks. They
received oral cannabis extract (211 patients), D9-tetrahydrocannabinol
(THC, 206 patients) or placebo (213). The study's primary outcome was
a change in overall spasticity scores, using the Ashworth scale.

The researchers found no evidence of a difference in spasticity scores
between patients given cannabinoids compared with those given placebo.
However, the patients given cannabis did report some improvements in
spasticity and pain.

Improvement in spasticity was reported in 61%, 60% and 46% of
participants on cannabis extract, THC and placebo,
respectively.

These findings are consistent with those of smaller studies which have
shown some subjective, but not observer-verified, improvement in
disease-related spasticity with the use of cannabinoids, said Dr. Zajicek.

One unexpected finding was that there were fewer hospital admissions
for relapses in the two active treatment groups compared with placebo.
Also, there was an improvement in walking time in all three groups
(12% in the patients who received THC compared with 4% in both the
cannabis extract and placebo groups).

"We now have evidence that what our patients have been telling us
about smoked cannabis holds up in a clinical trial," said neurologist
Dr. Luanne Metz, associate professor in the department of clinical
neurosciences at the University of Calgary. Further studies to
evaluate cannabis as a treatment for MS are needed, suggested Dr.
Metz, author of a commentary that accompanied the publication of the
study .

"I realize the primary outcome of the study was not met but that
outcome measured one aspect of spasticity only. It doesn't correlate
with function. We need to keep that in mind when we look at other
things that we now know this drug does for people."

Current treatments for the symptom of spasticity are very limited and
of limited benefit, suggested Dr. Metz.

"They're wonderful for some people but we run up against the wall of
dose-limiting side-effects in most people that have significant
spasticity," she said in an interview.

"We need other treatments. If we have another choice that we can add
after we've tried the standard treatments, I think that we need to
consider that like we would any other treatment, not back off because
it's cannabis."

It's important to do further studies to evaluate the risks and
benefits of cannabinoids, she added, pointing out there are still
legal issues and real risks associated with smoking cannabis. "I
cannot promote smoking."