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Systematic review evaluates cannabinoid efficacy for multiple sclerosis spasticity
Researchers conducted a systematic review of twenty-seven randomised controlled trials to assess cannabinoids for multiple sclerosis spasticity. Combined tetrahydrocannabinol and cannabidiol extracts demonstrated modest improvements in patient-reported symptoms compared to placebos. However, the overall certainty of the evidence was graded as low due to significant clinical and methodological variations across the included trials.
- Analysis of twenty-seven trials with over 3,000 participants showed modest reductions in patient-reported spasticity.
- Combined THC and CBD extracts produced the most consistent therapeutic improvements compared to placebo.
- Side effects were common but generally mild to moderate, with serious adverse events occurring rarely.
- The clinical evidence carries low certainty due to high methodological heterogeneity among the studies.
Our view
The direction of effect is consistent and the safety profile is manageable, but the certainty of the evidence is graded low and the heterogeneity between trials is substantial. Read carefully, this supports THC:CBD extracts as an adjunctive option in refractory spasticity rather than a first-line one, and it makes patient-reported outcomes the measure that matters. It also sets a clear research priority: until dosing and outcome measures are standardised, trials in this field cannot be pooled without the methodological noise that limits this review.
Sources
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