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Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up.
J Neurol Neurosurg Psychiatry 2005; 76(12):1664-9JN

Abstract

OBJECTIVE

To test the effectiveness and long term safety of cannabinoids in multiple sclerosis (MS), in a follow up to the main Cannabinoids in Multiple Sclerosis (CAMS) study.

METHODS

In total, 630 patients with stable MS with muscle spasticity from 33 UK centres were randomised to receive oral Delta(9)-tetrahydrocannabinol (Delta(9)-THC), cannabis extract, or placebo in the main 15 week CAMS study. The primary outcome was change in the Ashworth spasticity scale. Secondary outcomes were the Rivermead Mobility Index, timed 10 metre walk, UK Neurological Disability Score, postal Barthel Index, General Health Questionnaire-30, and a series of nine category rating scales. Following the main study, patients were invited to continue medication, double blinded, for up to 12 months in the follow up study reported here.

RESULTS

Intention to treat analysis of data from the 80% of patients followed up for 12 months showed evidence of a small treatment effect on muscle spasticity as measured by change in Ashworth score from baseline to 12 months (Delta(9)-THC mean reduction 1.82 (n = 154, 95% confidence interval (CI) 0.53 to 3.12), cannabis extract 0.10 (n = 172, 95% CI -0.99 to 1.19), placebo -0.23 (n = 176, 95% CI -1.41 to 0.94); p = 0.04 unadjusted for ambulatory status and centre, p = 0.01 adjusted). There was suggestive evidence for treatment effects of Delta(9)-THC on some aspects of disability. There were no major safety concerns. Overall, patients felt that these drugs were helpful in treating their disease.

CONCLUSIONS

These data provide limited evidence for a longer term treatment effect of cannabinoids. A long term placebo controlled study is now needed to establish whether cannabinoids may have a role beyond symptom amelioration in MS.

Authors+Show Affiliations

Department of Mathematics and Statistics, University of Plymouth, Room N16, ITTC Building, Tamar Science Park, Plymouth, Devon PL6 8BX, UK. john.zajicek@phnt.swest.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16291891

Citation

Zajicek, J P., et al. "Cannabinoids in Multiple Sclerosis (CAMS) Study: Safety and Efficacy Data for 12 Months Follow Up." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 76, no. 12, 2005, pp. 1664-9.
Zajicek JP, Sanders HP, Wright DE, et al. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry. 2005;76(12):1664-9.
Zajicek, J. P., Sanders, H. P., Wright, D. E., Vickery, P. J., Ingram, W. M., Reilly, S. M., ... Thompson, A. J. (2005). Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. Journal of Neurology, Neurosurgery, and Psychiatry, 76(12), pp. 1664-9.
Zajicek JP, et al. Cannabinoids in Multiple Sclerosis (CAMS) Study: Safety and Efficacy Data for 12 Months Follow Up. J Neurol Neurosurg Psychiatry. 2005;76(12):1664-9. PubMed PMID: 16291891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. AU - Zajicek,J P, AU - Sanders,H P, AU - Wright,D E, AU - Vickery,P J, AU - Ingram,W M, AU - Reilly,S M, AU - Nunn,A J, AU - Teare,L J, AU - Fox,P J, AU - Thompson,A J, PY - 2005/11/18/pubmed PY - 2005/12/15/medline PY - 2005/11/18/entrez SP - 1664 EP - 9 JF - Journal of neurology, neurosurgery, and psychiatry JO - J. Neurol. Neurosurg. Psychiatry VL - 76 IS - 12 N2 - OBJECTIVE: To test the effectiveness and long term safety of cannabinoids in multiple sclerosis (MS), in a follow up to the main Cannabinoids in Multiple Sclerosis (CAMS) study. METHODS: In total, 630 patients with stable MS with muscle spasticity from 33 UK centres were randomised to receive oral Delta(9)-tetrahydrocannabinol (Delta(9)-THC), cannabis extract, or placebo in the main 15 week CAMS study. The primary outcome was change in the Ashworth spasticity scale. Secondary outcomes were the Rivermead Mobility Index, timed 10 metre walk, UK Neurological Disability Score, postal Barthel Index, General Health Questionnaire-30, and a series of nine category rating scales. Following the main study, patients were invited to continue medication, double blinded, for up to 12 months in the follow up study reported here. RESULTS: Intention to treat analysis of data from the 80% of patients followed up for 12 months showed evidence of a small treatment effect on muscle spasticity as measured by change in Ashworth score from baseline to 12 months (Delta(9)-THC mean reduction 1.82 (n = 154, 95% confidence interval (CI) 0.53 to 3.12), cannabis extract 0.10 (n = 172, 95% CI -0.99 to 1.19), placebo -0.23 (n = 176, 95% CI -1.41 to 0.94); p = 0.04 unadjusted for ambulatory status and centre, p = 0.01 adjusted). There was suggestive evidence for treatment effects of Delta(9)-THC on some aspects of disability. There were no major safety concerns. Overall, patients felt that these drugs were helpful in treating their disease. CONCLUSIONS: These data provide limited evidence for a longer term treatment effect of cannabinoids. A long term placebo controlled study is now needed to establish whether cannabinoids may have a role beyond symptom amelioration in MS. SN - 0022-3050 UR - https://www.unboundmedicine.com/medline/citation/16291891/Cannabinoids_in_multiple_sclerosis__CAMS__study:_safety_and_efficacy_data_for_12_months_follow_up_ L2 - http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=16291891 DB - PRIME DP - Unbound Medicine ER -