THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study

Lower urinary tract dysfunctions (LUTDs) are commonly reported in multiple sclerosis (MS) patients and are mainly related to neurogenic overactive bladder (OAB). The aim of this observational study was to assess the effect of a tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray on resistant...

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Bibliographic Details
Published in:Neurological sciences 2018, Vol.39 (1), p.97-102
Main Authors: Maniscalco, Giorgia Teresa, Aponte, R., Bruzzese, D., Guarcello, G., Manzo, V., Napolitano, M., Moreggia, O., Chiariello, F., Florio, C.
Format: Article
Language:English
Subjects:
Administration, Mucosal
Administration, Oral
Bladder
Cannabidiol - administration & dosage
Cannabidiol - therapeutic use
Cannabinoids
Dronabinol - administration & dosage
Dronabinol - therapeutic use
Drug Combinations
Female
Humans
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Middle Aged
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - drug therapy
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Original Article
Pilot Projects
Pressure
Prospective Studies
Psychiatry
Spasticity
Statistical analysis
Tetrahydrocannabinol
THC
Treatment Outcome
Urinary bladder
Urinary Bladder, Overactive - complications
Urinary Bladder, Overactive - drug therapy
Urinary tract
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Summary:Lower urinary tract dysfunctions (LUTDs) are commonly reported in multiple sclerosis (MS) patients and are mainly related to neurogenic overactive bladder (OAB). The aim of this observational study was to assess the effect of a tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray on resistant OAB by means of clinical and instrumental tools. Twenty-one MS patients were screened, and 15 cases have been evaluated. They underwent a specific clinical assessment (overactive bladder symptom score, OABSS) and a urodynamic assessment evaluating the maximal cystometric capacity (CCmax), bladder compliance (Qmax), maximum detrusor pressure (Pdet max), detrusor pressure at the first desire (Pdet first), bladder volume at the first desire (BVFD), leakage volume (LV), and post-void residual volume (PVR), before and after 4 weeks of THC/CBD administration. A complete neurological evaluation, including the assessment of their spasticity using the Modified Ashworth Scale (MAS) and the spasticity 0–10 numerical rating scale (NRS), was performed at the same times. Mobility was evaluated through the 25-ft walking-time test (T25-WT). The THC/CBD treatment successfully reduced the OAB symptoms ( p  = 0.001). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced ( p  = 0.016). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced ( p  = 0.016), while BVFD and CCmax were increased although the difference was not statistically significant. THC/CBD oromucosal spray has shown to be effective in improving overactive bladder symptoms in MS patients demonstrating a favorable impact on detrusor overactivity.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-017-3148-6