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THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study.
Neurol Sci. 2018 Jan; 39(1):97-102.NS

Abstract

Lower urinary tract dysfunctions (LUTDs) are commonly reported in multiple sclerosis (MS) patients and are mainly related to neurogenic overactive bladder (OAB). The aim of this observational study was to assess the effect of a tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray on resistant OAB by means of clinical and instrumental tools. Twenty-one MS patients were screened, and 15 cases have been evaluated. They underwent a specific clinical assessment (overactive bladder symptom score, OABSS) and a urodynamic assessment evaluating the maximal cystometric capacity (CCmax), bladder compliance (Qmax), maximum detrusor pressure (Pdet max), detrusor pressure at the first desire (Pdet first), bladder volume at the first desire (BVFD), leakage volume (LV), and post-void residual volume (PVR), before and after 4 weeks of THC/CBD administration. A complete neurological evaluation, including the assessment of their spasticity using the Modified Ashworth Scale (MAS) and the spasticity 0-10 numerical rating scale (NRS), was performed at the same times. Mobility was evaluated through the 25-ft walking-time test (T25-WT). The THC/CBD treatment successfully reduced the OAB symptoms (p = 0.001). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced (p = 0.016). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced (p = 0.016), while BVFD and CCmax were increased although the difference was not statistically significant. THC/CBD oromucosal spray has shown to be effective in improving overactive bladder symptoms in MS patients demonstrating a favorable impact on detrusor overactivity.

Authors+Show Affiliations

Multiple Sclerosis Center "A Cardarelli" Hospital, Via "A Cardarelli" n.9, Naples, Italy. gtmaniscalco@libero.it. Neurological Clinic "A. Cardarelli" Hospital, Via "A.Cardarelli" n.9, Naples, Italy. gtmaniscalco@libero.it.Urological Clinic of "A. Cardarelli" Hospital, Via "A.Cardarelli" n.9, Naples, Italy.Department of Public Health, University of Naples "Federico II", Via Sergio Pansini, Naples, Italy.Multiple Sclerosis Center "A Cardarelli" Hospital, Via "A Cardarelli" n.9, Naples, Italy.Neurological Clinic "A. Cardarelli" Hospital, Via "A.Cardarelli" n.9, Naples, Italy.Neurological Clinic "A. Cardarelli" Hospital, Via "A.Cardarelli" n.9, Naples, Italy.Multiple Sclerosis Center "A Cardarelli" Hospital, Via "A Cardarelli" n.9, Naples, Italy.Urological Clinic of "A. Cardarelli" Hospital, Via "A.Cardarelli" n.9, Naples, Italy.Multiple Sclerosis Center "A Cardarelli" Hospital, Via "A Cardarelli" n.9, Naples, Italy. Neurological Clinic "A. Cardarelli" Hospital, Via "A.Cardarelli" n.9, Naples, Italy.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29052091

Citation

Maniscalco, Giorgia Teresa, et al. "THC/CBD Oromucosal Spray in Patients With Multiple Sclerosis Overactive Bladder: a Pilot Prospective Study." Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol. 39, no. 1, 2018, pp. 97-102.
Maniscalco GT, Aponte R, Bruzzese D, et al. THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study. Neurol Sci. 2018;39(1):97-102.
Maniscalco, G. T., Aponte, R., Bruzzese, D., Guarcello, G., Manzo, V., Napolitano, M., Moreggia, O., Chiariello, F., & Florio, C. (2018). THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 39(1), 97-102. https://doi.org/10.1007/s10072-017-3148-6
Maniscalco GT, et al. THC/CBD Oromucosal Spray in Patients With Multiple Sclerosis Overactive Bladder: a Pilot Prospective Study. Neurol Sci. 2018;39(1):97-102. PubMed PMID: 29052091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study. AU - Maniscalco,Giorgia Teresa, AU - Aponte,R, AU - Bruzzese,D, AU - Guarcello,G, AU - Manzo,V, AU - Napolitano,M, AU - Moreggia,O, AU - Chiariello,F, AU - Florio,C, Y1 - 2017/10/19/ PY - 2017/05/03/received PY - 2017/10/06/accepted PY - 2017/10/21/pubmed PY - 2018/8/16/medline PY - 2017/10/21/entrez KW - Cannabinoids KW - LUTDs KW - Multiple sclerosis KW - Nabiximols KW - Sativex KW - Spasticity SP - 97 EP - 102 JF - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JO - Neurol. Sci. VL - 39 IS - 1 N2 - Lower urinary tract dysfunctions (LUTDs) are commonly reported in multiple sclerosis (MS) patients and are mainly related to neurogenic overactive bladder (OAB). The aim of this observational study was to assess the effect of a tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray on resistant OAB by means of clinical and instrumental tools. Twenty-one MS patients were screened, and 15 cases have been evaluated. They underwent a specific clinical assessment (overactive bladder symptom score, OABSS) and a urodynamic assessment evaluating the maximal cystometric capacity (CCmax), bladder compliance (Qmax), maximum detrusor pressure (Pdet max), detrusor pressure at the first desire (Pdet first), bladder volume at the first desire (BVFD), leakage volume (LV), and post-void residual volume (PVR), before and after 4 weeks of THC/CBD administration. A complete neurological evaluation, including the assessment of their spasticity using the Modified Ashworth Scale (MAS) and the spasticity 0-10 numerical rating scale (NRS), was performed at the same times. Mobility was evaluated through the 25-ft walking-time test (T25-WT). The THC/CBD treatment successfully reduced the OAB symptoms (p = 0.001). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced (p = 0.016). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced (p = 0.016), while BVFD and CCmax were increased although the difference was not statistically significant. THC/CBD oromucosal spray has shown to be effective in improving overactive bladder symptoms in MS patients demonstrating a favorable impact on detrusor overactivity. SN - 1590-3478 UR - https://www.unboundmedicine.com/medline/citation/29052091/THC/CBD_oromucosal_spray_in_patients_with_multiple_sclerosis_overactive_bladder:_a_pilot_prospective_study_ L2 - https://dx.doi.org/10.1007/s10072-017-3148-6 DB - PRIME DP - Unbound Medicine ER -