Table 4. Clinical studies of cannabinoids in multiple sclerosis.

Study	Product	Design	No. of Pts	“Result”	Other comment
Killestein, 2002	THC vs. C. sativa extract	20 wks, R, DB, Placebo	16	No change AS	Worsening in MSFC
CAMS, Zajicek, 2003	Marinol, Cannador	15 wks, R, Placebo	667	No signif change in AS	↓ 10 m walking time; subj imp. Spasticity, pain
Vaney, 2004	THC 2.5 mg CBD 0.9 mg	Pro, R, DB, placebo, X-over	57	No signif diff	trend in favor of ↓ spasm freq; imp. sleep, mobility
CAMS-ext Zajicek, 2005	Marinol, Cannador	Up to 12 mos	502 (80% of CAMS)	Small imp AS, Marinol + Cannador
Wade, 2006	Sativex	Open label, ~434 days, sub 6 wks placebo controlled	137	↓ in VAS score; pain, tremor, bladder—neg	42.3% withdrew from lack of efficacy
Collin, 2007	Sativex	6 wks, DB, Placebo cont	189	↓ spasticity by NRS score	No other sign effect
Novotna, 2011	Sativex	Unusual design: initial 4 wks single blind; Phase B: R, DB, Placebo with “early responders”	572 phase A 241 phase B	Highly sign improvement spasticity (NRS) in phase B	Also, ↓ freq of spasms, sleep disturbances
Notcutt, 2012	Sativex	Blinded withdrawal in long-term treated pts	36 (18 per group)	Time to treatment failure	Global imp of change scales (pt and caregiver)

CBD, cannabidiol; AS, Ashworth scale (“objective” spasticity scale); MSFC, MS Functional Composite; VAS, visual analogue scale rating spasticity subjectively; NRS, subjective numerical rating scale for spasticity; wks, weeks; mos, months; pts, patients; signif, significant; diff, difference; freq, frequency; subj, subject; imp, important; neg, negative. Marinol, synthetic THC; Cannador, oral C. Sativa extract.