Patti, FrancescoGrazia-Chisari, ClaraFernandez, OscarSarroca, JorgeFerrer-Picon, ElenaHernandez-Vicente, FranciscoVila-Silvan, Carlos2023-05-032023-05-032022-04-29Patti F, Chisari CG, Fernández Ó, Sarroca J, Ferrer-Picón E, Hernández Vicente F, et al. A real-world evidence study of nabiximols in multiple sclerosis patients with resistant spasticity: Analysis in relation to the newly described 'spasticity-plus syndrome'. Eur J Neurol. 2022 Sep;29(9):2744-2753http://hdl.handle.net/10668/19955Nabiximols 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'. We 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. Common 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. This real-world analysis supports the concept of a spasticity-plus syndrome and suggests that nabiximols can favorably impact a range of spasticity-associated symptoms.enAttribution-NonCommercial 4.0 Internationale-Registry analysisMultiple sclerosisNabiximolsSpasticity-plus syndromeSpasticity-related symptomsCannabidiolCentral Nervous System DiseasesDronabinolDrug CombinationsHumansMultiple SclerosisMuscle CrampMuscle SpasticityPainSpasmTreatment Outcomeresearch article35590453open accessEspasmoCalambre muscularSueñoSistema de registrosEsclerosis múltipleCuidados posteriores10.1111/ene.154121468-1331PMC9539865https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9539865https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9539865/pdf