Effect of tetrahydrocannabinol: cannabidiol oromucosal spray on activities of daily living in multiple sclerosis patients with resistant spasticity: a retrospective, observational study

A Summary points Evolution in activities of daily living in patients with moderate to severe multiple sclerosis spasticity receiving add-on tetrahydrocannabinol: cannabidiol (THC: CBD) oromucosal spray was assessed using a 16-item survey. Compared with baseline status before treatment, THC: CBD oromucosal spray produced a general improvement in activities of daily living including a statistically significant improvement in the item 'standing up' (p < 0.05). THC: CBD oromucosal spray also produced statistically significant improvements (p < 0.01) in spasticity severity, number of spasms per day, pain, sleep disorders and bladder dysfunction. Overall, 96.9% of patients provided positive feedback regarding their global impression of change under treatment with THC: CBD oromucosal spray and 78.1% were positive about its overall tolerability. Aim: To examine evolution in activities of daily living (ADL) in patients with multiple sclerosis spasticity during long-term use of tetrahydrocannabinol (THC): cannabidiol (CBD) oromucosal spray. Methods: Functional impairment was assessed retrospectively (prior to start of treatment) and at the present moment using a 16-item ADL survey; results were compared. A control group without add-on THC: CBD oromucosal spray was included to investigate possible recall bias. Results: ADL was maintained or slightly improved with THC: CBD oromucosal spray across treatment time (mean 31.9 months) including significant improvement in 'standing up' (p < 0.05) and trends in other items. Significant improvements (p < 0.01) with THC: CBD oromucosal spray were observed in several multiple sclerosis spasticity-related symptoms. Overall, 96.9% of patients using THC: CBD oromucosal spray had a positive global impression of change during treatment. Conclusion: In this pilot study, THC: CBD oromucosal spray maintained or improved aspects of daily functioning. Further study in a larger trial is warranted.