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

Massimiliano Mirabella, Gabriela Grimaldi, Assunta Bianco, Alessandro Enrico Grimaldi, Laura De Giglio, Shalom Haggiag, Antonio Cortese, Sebastiano Giuseppe Crisafulli, Fabrizia Monteleone, Gerola Marfia, Luca Prosperini, Simonetta Galgani, Diego Centonze, Carlo Pozzilli, Letizia Castelli

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

2 Citazioni (Scopus)

Abstract

Background Nabiximols (THC/CBD Oromucosal Spray, Sativex) is used as an add-on therapy to treat moderate to severe spasticity of Multiple Sclerosis (MS). Objectives To examine the impact of physiotherapy (PT) programs on effectiveness and persistence of nabiximols treatment in people with MS-related spasticity. Methods This 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. Results A 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). Conclusions Our 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.
Lingua originaleEnglish
pagine (da-a)e0219670-N/A
RivistaPLoS One
Volume14
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Cannabidiol
  • Combined Modality Therapy
  • Dronabinol
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis
  • Muscle Spasticity
  • Oral Sprays
  • Physical Therapy Modalities
  • Withholding Treatment

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