Expert review of neurotherapeutics
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Expert Rev Neurother · Dec 2013
Review Multicenter StudyClinical case reviews in multiple sclerosis spasticity: experiences from around Europe.
Spasticity is one of the main symptoms associated with multiple sclerosis (MS). Epidemiological studies indicate that approximately two-thirds of MS patients experience spasticity and, in a relevant proportion of this group, spasticity is moderate to severe. ⋯ This review of MS spasticity cases from around Europe presents current knowledge of considerations for administration of a new agent (tetrahydrocannabinol/cannabidiol-based nabiximols [Sativex®] oromucosal spray) for management of MS spasticity, with the aim of ensuring appropriate and optimal use for best outcomes. Assessment of the European clinical experience is intended to provide a better understanding of the prescribing regulations for MS spasticity treatments, facilitate identification of suitable candidate patients for Sativex and increase awareness of alternative management approaches for MS-related spasticity.
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Expert Rev Neurother · Dec 2013
ReviewAdvances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.
Although spasticity of varying severity affects up to 80% of patients with multiple sclerosis (MS) during the course of their disease, the symptom is often overlooked and undertreated. Despite the availability of oral antispasticity treatments (baclofen, tizanidine and others), approximately one-third of MS patients in Europe and the USA experience moderate or severe nonfocalized spasticity. At present, a thorough clinical evaluation of MS-related spasticity that takes into account the patient's own perception of spasms, spasticity-related pain and other associated symptoms is not common in daily neurological practice. ⋯ In large observational studies, >80% of patients reported no adverse events with the use of Sativex and interim data from safety registries in the UK and Spain indicate a low risk for serious adverse drug reactions. Follow-up studies in Sativex responders support continued benefit without the need to increase doses for at least 1 year. Sativex appears to be a promising solution for a meaningful proportion of patients with MS-related spasticity who have inadequate response to current antispasticity medications.