ArticleEuropean journal of neurology2022
A real-world evidence study of nabiximols in multiple sclerosis patients with resistant spasticity: Analysis in relation to the newly described 'spasticity-plus syndrome'.
Article in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Nabiximols in Multiple Sclerosis: Beyond Spasticity-An Exploratory Systematic Review and Meta-Analysis of Symptomatic Outcomes.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Patient-reported benefits from nabiximols treatment in multiple sclerosis-related spasticity exceed conventional measures.Neurodegenerative disease management · 2024Trial
- Unveiling the role of CB2 receptor in beta-hydroxybutyrate mediated modulation of.Journal of physiology and biochemistry · 2026Article
- Acute cannabidiol (CBD), tetrahydrocannabinol (THC) and their mixture (THC:CBD) exert differential effects on brain activity and blood flow in rats: A translational neuroimaging study.Journal of psychopharmacology (Oxford, England) · 2026Article
- A proof-of-concept study on the effectiveness of botulinum toxin on spasticity plus syndrome in multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Nabiximols improves sleep architecture in multiple sclerosis: A prospective polysomnographic study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- Epigenetic and Mitochondrial Metabolic Dysfunction in Multiple Sclerosis: A Review of Herbal Drug Approaches and Current Clinical Trials.Molecular neurobiology · 2025Review
- Disease-Modifying Symptomatic Treatment (DMST) Potential of Cannabinoids in Patients with Multiple Sclerosis.Current neuropharmacology · 2025Review
- Anti-Cancer and Anti-Proliferative Potential of Cannabidiol: A Cellular and Molecular Perspective.International journal of molecular sciences · 2024Review
- Practical tool to identify Spasticity-Plus Syndrome amongst patients with multiple sclerosis. Algorithm development based on a conjoint analysis.Frontiers in neurology · 2024Article
- Effect of nabiximols oromucosal spray (SativexDrugs in context · 2024Article
- Spasticity-Plus syndrome in multiple sclerosis patients in a tertiary hospital in Spain.Frontiers in neurology · 2024Article
- Non-interventional, prospective, observational study on spasticity-associated symptom control with nabiximols as add-on therapy in patients with multiple sclerosis spasticity in Austria.Brain and behavior · 2023Observational
- Medical Cannabis: A Review from the American Society of Pain and Neuroscience.Journal of pain research · 2023Article
- A real-world evidence study of nabiximols in multiple sclerosis patients with resistant spasticity: Analysis in relation to the newly described 'spasticity-plus syndrome'.European journal of neurology · 2022Article
- Clinical insights on the spasticity-plus syndrome in multiple sclerosis.Frontiers in neurology · 2022Article
- Cannabinoids for spasticity in patients with multiple sclerosis: A systematic review and meta-analysis.Multiple sclerosis journal - experimental, translational and clinicalReview
- Enhancing the endocannabinoid system to treat residual disease in relapse-free multiple sclerosis.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeNabiximols is a therapeutic option for patients with multiple sclerosis (MS) spasticity whose symptoms are poorly controlled by conventional oral first-line medications. This study aimed to assess the relationship between changes in spasticity severity (measured on the 0-10 numeric rating scale [NRS]) and the presence of associated symptoms in patients treated with nabiximols, and to investigate the presence of the newly described 'spasticity-plus syndrome'.
methodsWe analyzed real-world data from the Italian Medicines Agency e-Registry on 1138 patients with MS spasticity who began treatment with nabiximols. Evaluation time points were baseline, 4 weeks, and 3, 6, 12 and 18 months after treatment start.
resultsCommon symptoms associated with MS spasticity in this cohort were pain (38.4% at baseline), sleep disturbances (32.7%), and spasms/cramps (28.5%). Pain was frequently clustered with sleep disturbances (57.2% of pain cases) and spasms/cramps (43.9%). Approximately one-third of patients with data at all evaluation time points maintained treatment at 18 months. Nabiximols reduced the baseline mean spasticity 0-10 NRS score by 24.6% at Week 4, and by 33.9% at 18 months in treatment continuers. Nabiximols resolved a range of MS spasticity-associated symptoms at Week 4, and after 18 months in treatment continuers.
conclusionThis real-world analysis supports the concept of a spasticity-plus syndrome and suggests that nabiximols can favorably impact a range of spasticity-associated symptoms.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.