BackgroundNabiximols (THC/ CBD Oromucosal Spray, Sativex) is used as an add-on therapy to treat moderate to severe spasticity of Multiple Sclerosis (MS).ObjectivesTo examine the impact of physiotherapy (PT) programs on effectiveness and persistence of nabiximols treatment in people with MS-related spasticity.MethodsThis is an observational multicenter study with a follow-up period of 12 weeks, conducted in routine care settings in Italy. Patients with moderate to severe MS-related spasticity who started nabiximols were included. Spasticity was evaluated by the patient-rated 0-10 numerical rating scale (NRS). Clinical data were collected at baseline (T0), 4 weeks (T1) and 12 weeks (T2) months after enrollment.ResultsA total of 297 MS patients were selected, 290 completed the 3 months follow-up period. Mean NRS scores were 7.6 +/- 1.1 at T0, 5.8 +/- 1.4 at T1 and 5.5 +/- 1.5 at T2. At T1, 77% of patients reached. 20% improvement (initial response, IR); 22% reached. 30% improvement (clinically relevant response, CRR). At T1, patients undergoing PT had a higher probability to reach CRR (Odds Ratio = 2.6 95% CI 1.3-5.6, p = 0.01). Nabiximols was discontinued in 30/290 (10.3%) patients at T1 (early discontinuers) and in 71/ 290 (24.5%) patients at T2 (late discontinuers). The probability of being late discontinuers was reduced in patients undergoing PT (Hazard Ratio = 0.41; 95% CI 0.23-0.69, p = 0.001).ConclusionsOur real-life study confirms nabiximols' effectiveness in MS-related spasticity and suggests that the association of a PT program may improve overall response and persistence to nabiximols treatment.

Grimaldi, A.e., De Giglio, L., Haggiag, S., Bianco, A., Cortese, A., Crisafulli, S.g., et al. (2019). The influence of physiotherapy intervention on patients with multiple sclerosis–related spasticity treated with nabiximols (THC:CBD oromucosal spray). PLOS ONE, 14(7), e0219670 [10.1371/journal.pone.0219670].

The influence of physiotherapy intervention on patients with multiple sclerosis–related spasticity treated with nabiximols (THC:CBD oromucosal spray)

Monteleone F.;Marfia G.;Centonze D.;
2019-07-01

Abstract

BackgroundNabiximols (THC/ CBD Oromucosal Spray, Sativex) is used as an add-on therapy to treat moderate to severe spasticity of Multiple Sclerosis (MS).ObjectivesTo examine the impact of physiotherapy (PT) programs on effectiveness and persistence of nabiximols treatment in people with MS-related spasticity.MethodsThis is an observational multicenter study with a follow-up period of 12 weeks, conducted in routine care settings in Italy. Patients with moderate to severe MS-related spasticity who started nabiximols were included. Spasticity was evaluated by the patient-rated 0-10 numerical rating scale (NRS). Clinical data were collected at baseline (T0), 4 weeks (T1) and 12 weeks (T2) months after enrollment.ResultsA total of 297 MS patients were selected, 290 completed the 3 months follow-up period. Mean NRS scores were 7.6 +/- 1.1 at T0, 5.8 +/- 1.4 at T1 and 5.5 +/- 1.5 at T2. At T1, 77% of patients reached. 20% improvement (initial response, IR); 22% reached. 30% improvement (clinically relevant response, CRR). At T1, patients undergoing PT had a higher probability to reach CRR (Odds Ratio = 2.6 95% CI 1.3-5.6, p = 0.01). Nabiximols was discontinued in 30/290 (10.3%) patients at T1 (early discontinuers) and in 71/ 290 (24.5%) patients at T2 (late discontinuers). The probability of being late discontinuers was reduced in patients undergoing PT (Hazard Ratio = 0.41; 95% CI 0.23-0.69, p = 0.001).ConclusionsOur real-life study confirms nabiximols' effectiveness in MS-related spasticity and suggests that the association of a PT program may improve overall response and persistence to nabiximols treatment.
lug-2019
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/26 - NEUROLOGIA
English
Con Impact Factor ISI
Cannabidiol; Combined Modality Therapy; Dronabinol; Drug Combinations; Female; Follow-Up Studies; Humans; Male; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Withholding Treatment; Oral Sprays; Physical Therapy Modalities
Grimaldi, A.e., De Giglio, L., Haggiag, S., Bianco, A., Cortese, A., Crisafulli, S.g., et al. (2019). The influence of physiotherapy intervention on patients with multiple sclerosis–related spasticity treated with nabiximols (THC:CBD oromucosal spray). PLOS ONE, 14(7), e0219670 [10.1371/journal.pone.0219670].
Grimaldi, Ae; De Giglio, L; Haggiag, S; Bianco, A; Cortese, A; Crisafulli, Sg; Monteleone, F; Marfia, G; Prosperini, L; Galgani, S; Mirabella, M; Centonze, D; Pozzilli, C; Castelli, L
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/236875
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