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A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis.
Expert Rev Neurother. 2018 10; 18(10):785-791.ER

Abstract

INTRODUCTION

Multiple sclerosis (MS) is a complex disease with a heterogeneous and unpredictable clinical course. Mobility impairment after progressive paralyses and muscle tone spasticity is common. Areas covered: The prevalence, assessment, and pharmacological management of gait impairment and spasticity in MS and their effects on health-related quality of life (HRQoL) are discussed. The roles of oral and intrathecal baclofen and of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) oromucosal spray in treating MS spasticity-related gait impairment are reviewed. Expert commentary: Mobility impairment and spasticity are experienced by approximately 90% and 80% of MS patients, respectively, during the disease course. Prevalence and severity of gait impairment and spasticity increase as disease progresses. The symptoms are related and both impact negatively on HRQoL. Oral baclofen and tizanidine are generally used for first-line treatment of MS spasticity but are ineffective in approximately 40% of cases. Second-line therapy includes add-on THC:CBD spray for patients with resistant MS spasticity. Results of studies evaluating baclofen for treating MS spasticity gait impairment are equivocal. In studies of patients with resistant MS spasticity, THC:CBD spray consistently improved the timed 10-meter walk test and significantly improved multiple spatial-temporal and kinematic gait parameters. THC:CBD oromucosal spray warrants further investigation as a treatment for MS spasticity-related gait impairment.

Authors+Show Affiliations

a Neurology Department , Hospital Universitario Quironsalud Madrid , Pozuelo de Alarcón, Madrid , Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

30235965

Citation

Arroyo González, Rafael. "A Review of the Effects of Baclofen and of THC:CBD Oromucosal Spray On Spasticity-related Walking Impairment in Multiple Sclerosis." Expert Review of Neurotherapeutics, vol. 18, no. 10, 2018, pp. 785-791.
Arroyo González R. A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis. Expert Rev Neurother. 2018;18(10):785-791.
Arroyo González, R. (2018). A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis. Expert Review of Neurotherapeutics, 18(10), 785-791. https://doi.org/10.1080/14737175.2018.1510772
Arroyo González R. A Review of the Effects of Baclofen and of THC:CBD Oromucosal Spray On Spasticity-related Walking Impairment in Multiple Sclerosis. Expert Rev Neurother. 2018;18(10):785-791. PubMed PMID: 30235965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis. A1 - Arroyo González,Rafael, Y1 - 2018/09/20/ PY - 2018/9/22/pubmed PY - 2019/6/20/medline PY - 2018/9/22/entrez KW - Baclofen KW - THC:CBD oromucosal spray KW - gait impairment KW - multiple sclerosis KW - spasticity SP - 785 EP - 791 JF - Expert review of neurotherapeutics JO - Expert Rev Neurother VL - 18 IS - 10 N2 - INTRODUCTION: Multiple sclerosis (MS) is a complex disease with a heterogeneous and unpredictable clinical course. Mobility impairment after progressive paralyses and muscle tone spasticity is common. Areas covered: The prevalence, assessment, and pharmacological management of gait impairment and spasticity in MS and their effects on health-related quality of life (HRQoL) are discussed. The roles of oral and intrathecal baclofen and of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) oromucosal spray in treating MS spasticity-related gait impairment are reviewed. Expert commentary: Mobility impairment and spasticity are experienced by approximately 90% and 80% of MS patients, respectively, during the disease course. Prevalence and severity of gait impairment and spasticity increase as disease progresses. The symptoms are related and both impact negatively on HRQoL. Oral baclofen and tizanidine are generally used for first-line treatment of MS spasticity but are ineffective in approximately 40% of cases. Second-line therapy includes add-on THC:CBD spray for patients with resistant MS spasticity. Results of studies evaluating baclofen for treating MS spasticity gait impairment are equivocal. In studies of patients with resistant MS spasticity, THC:CBD spray consistently improved the timed 10-meter walk test and significantly improved multiple spatial-temporal and kinematic gait parameters. THC:CBD oromucosal spray warrants further investigation as a treatment for MS spasticity-related gait impairment. SN - 1744-8360 UR - https://www.unboundmedicine.com/medline/citation/30235965/A_review_of_the_effects_of_baclofen_and_of_THC:CBD_oromucosal_spray_on_spasticity_related_walking_impairment_in_multiple_sclerosis_ L2 - http://www.tandfonline.com/doi/full/10.1080/14737175.2018.1510772 DB - PRIME DP - Unbound Medicine ER -