Pain intensity of chronic non-cancer patients was reduced by cannabinoids consumption , but effect sizes were small .
Efficacy for neuropathic and non-neuropathic pain was similar
There is growing interest in using cannabinoids for chronic pain .
We performed a systematic review and meta- analysis of r and omized controlled trials to evaluate the analgesic efficacy and adverse effects of cannabinoids for chronic non-cancer pain .
Sativex® and clinical–neurophysiological measures of spasticity in progressive multiple sclerosis
Despite the proven efficacy of Sativex ® ( 9-delta-tetrahydrocannabinol plus cannabidiol ) oromucosal spray in reducing spasticity symptoms in multiple sclerosis ( MS ) , little is known about the neurophysiological correlates of such effects . The aim of the study was to investigate the effects of Sativex on neurophysiological measures of spasticity ( H/M ratio ) and corticospinal excitability in patients with progressive MS . This was a r and omized , double-blind , placebo-controlled , crossover study . Consecutive subjects with progressive MS and lower limb spasticity referred to our center were r and omized to 4 weeks ’ treatment ( including 2 weeks ’ titration ) with Sativex or placebo , with crossover after a 2-week washout . Clinical and neurophysiological measures ( H/M ratio and cortical excitability ) of spasticity were assessed . The H/M ratio was the primary outcome , with sample size calculation of 40 patients . Of 44 recruited patients , 34 were analyzed due to 6 drop-outs and 4 exclusions , which lowered the power of the study to show differences between treatments . Neurophysiological measures did not differ significantly according to treatment and did not correlate significantly with clinical response . Response on the modified Ashworth scale ( at least 20 % improvement ) was significantly more frequent after Sativex than placebo ( 50 vs 23.5 % ; p = 0.041 ; McNemar ) . Side effects did not differ significantly according to treatment . Our findings confirm the clinical benefit of Sativex  on MS spasticity . The lack of corresponding changes in corticospinal excitability and on the monosynaptic component , of the stretch reflex , although in a limited sample size , points to the involvement of other spinal and supraspinal mechanisms in the physiopathology of spasticity in progressive MS
Pain intensity of chronic non-cancer patients was reduced by cannabinoids consumption , but effect sizes were small .
Efficacy for neuropathic and non-neuropathic pain was similar
There is growing interest in using cannabinoids for chronic pain .
We performed a systematic review and meta- analysis of r and omized controlled trials to evaluate the analgesic efficacy and adverse effects of cannabinoids for chronic non-cancer pain .