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|Title||Randomised controlled trial of cannabis based medicinal extracts (CBME) in central neuropathic pain due to multiple sclerosis.|
|Author(s)|| Young CA, Rog DJ|
|Journal, Volume, Issue||IV. Congress of the European Federation of IASP Chapters (EFIC), September 2-6 2003, Prague|
|Major outcome(s)||Significant reduction in pain|
Background: Central neuropathic pain can be an intractable problem for some multiple sclerosis (MS) patients.
Aim: To evaluate the efficacy and safety of THC:CBD CBME in the relief of central neuropathic pain due to MS, using the Neuropathic Pain Scale (NPS) and single Box Scale-11 (BS-11) pain severity score.
Methods: A 5-week (1 week run-in, 4 week treatment), randomised, double-blinded, placebo-controlled, parallel group trial in 66 MS patients was conducted.
The study medication was an oro-mucosal preparation of a whole plant extract which delivered 2.7mg of THC and 2.5mg CBD per spray. Patients were allowed to self-titrate up to a maximum of 48 sprays per day.
Results: Sixty-four patients (96.9%) completed the trial (n=32 CBME, n=32 placebo).
Efficacy: Significant mean reductions in pain were observed at Week 4 for CBME compared to placebo, using both BS-11 score (p=0.005) and Neuropathic Pain Scale (NPS) scores (p=0.039).
A statistically significant reduction in sleep disturbance using a 0-10 scale (p=0.003), and a greater overall impression of change (p=0.005) in favour of CBME was observed.
Safety: Thirty patients (88.2%) on CBME and 22 (68.8%) on placebo had at least one adverse event; however only 1 patient (CBME) withdrew from the study.
There was a small, but statistically significant mean difference between treatments in the long term storage component of the Selective Reminding Test, in favour of placebo (p = 0.009).
Conclusion: CBME showed significant reductions in both neuropathic pain and pain-related sleep disturbance in patients with MS. CBMEs appear well tolerated by most patients.
|Dose(s)||up to 130 mg per day|
|Participants||66 multiple sclerosis patients|
|Type of publication||Meeting abstract|
|Address of author(s)||The Walton Centre for Neurology & Neurosurgery, Liverpool, UK|