Researchers from the Imperial College Medical Cannabis Research Group have published a study showing that patients with Multiple Sclerosis (MS) report significant improvements in health-related quality of life after 6 months of treatment with cannabis.
Current treatment for MS focuses on slowing down the progression of the neurodegenerative disease, these therapies are known as disease-modifying therapies or DMTs. However, DMTs don’t always help with the additional symptoms or complications sometimes experienced alongside and possibly because of MS. These symptoms include pain, muscle spasms, cognitive decline, and more.
“…common symptoms include pain, motor and sensory deficiencies, spasticity, and cognitive deficits. Individuals with MS also have a higher prevalence of psychiatric disorders secondary to the significant impact on physical health, the adverse effects of steroid therapy for acute flares, as well as neurobiological changes. Moreover, there is often a subsequent decline in social and economic health,” the study said.
The researchers aimed to assess the efficacy and safety of cannabis-based medicinal products (CBMPs) for the treatment of these symptoms and to evaluate if cannabis could help improve the overall quality of life of those living with MS.
The study involved 141 patients living with MS who were being prescribed CBMPs at the time and were actively part of the UKMCR scheme which collects data from UK cannabis patients.
All participants completed online assessments used by researchers to evaluate their associated MS symptoms.
The assessments were:
- The EQ-5D-5L measures five different factors linked to quality of life, mobility, self-care, usual activities, pain or discomfort, anxiety or depression
- The GAD-7 is a tool for screening for and measuring the severity of generalised anxiety disorder
- The SQS scale that records sleep quality
- The Patient Global Impression of Change (PGIC) is a measure of perceived change in symptoms since commencing therapy (in this case cannabis therapy)
- The Multiple Sclerosis Quality of Life-54 (MSQoL-54) which is described by the study: “measures HRQoL [general health-related quality of life] with specific attribution to the effects of living with MS. It includes 15 subscales encompassing both physical and mental health: ‘change in health scale’, ‘cognitive function’, ‘emotional wellbeing’, ‘energy scale’, ‘health distress scale’, ‘health perception’, ‘pain scale’, ‘physical function’, ‘physical health’, ‘role limitations due to physical limitation’, ‘role limitations due to emotional problems’, ‘satisfaction with sexual function’, ‘sexual function’, ‘social function’, and ‘overall quality of life’. These are also incorporated within the mental and physical health composite values.”
Analysing the data produced from these tests showed that many patients benefitted from their cannabis prescriptions. Patients reported improvements in nearly all areas, with no serious adverse effects. Nearly all of the improvements were seen to be maintained at the 3-month and the 6-month stage.
“This case series demonstrates a potential association between initiation of CBMPs and improved patient-reported outcomes in sleep, anxiety and general HRQoL measures, over 6 months. This analysis indicated improvements in validated measures including EQ-5D-5L, GAD-7 and SQS over a 6-month follow-up period. Additional measures for HRQoL, including various physical and mental health subdomains assessed through the MSQoL-54, also exhibit improvements up to 6 months when compared to baseline,” the study said.
The researchers were clear that solid conclusions shouldn’t be drawn from this data set alone as the study had drawbacks, such as the low number of participants and the self-reported nature of the results. They also stated there is a need for additional research in this field.
“This case series is the first to assess the follow-up of MS patients, prescribed unlicensed CBMPs, for up to 6 months. The results obtained from this study have indicated an association between treatment with CBMPs and improved general HRQoL outcomes in the short-to-medium term. Despite there being a total of 146 adverse events reported, the results demonstrate that within the first 6 months, CBMP treatment was well-tolerated by the majority of patients (85.11%). However, the inherent limitations of this study must be taken into consideration when interpreting the results and conclusions should tentatively be drawn. This study highlights the need for future randomised controlled trials to further explore CBMP use for MS patients and clear the ambiguities surrounding the incidence of adverse events,” the study concluded.
