The purpose of this study is to determine the effective dose range and to demonstrate a non-effective dose range of Sativex compared with placebo in relieving symptoms of spasticity due to multiple sclerosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Contains delta -9 tetrahydrocannabinol (THC), 27 mg/mL:cannabidiol (CBD), 25 mg/mL, in ethanol:propylene glycol (50:50) excipients, with peppermint oil (0.05%) flavoring. Subjects receive study medication delivered in 100 microlitre actuations by a pump action oromucosal spray. Maximum permitted dose is 10 actuations per day. Each actuation delivers THC 2.7 mg and CBD 2.5 mg.
Oromucosal spray, containing no active drug but ethanol:propylene glycol (50:50) excipients, with peppermint oil (0.05%) flavoring and colorants. Maximum permitted dose is 10 actuations per day.
Physician Global Impression of Change (PGIC) questionnaire
Time frame: This is completed by the physician at each visit whilst using the study medication.
Change in mean Modified Ashworth Scale score from baseline to the end of treatment period.
All 20 muscle groups were assessed for spasticity (using a 0-4 scale): 0= no increase in muscle tone to 4=considerable increase in muscle tone, passive movement is difficult. The score for all 20 muscle groups were added to give a total score out of 80. A decrease in score indicates an improvement in condition.
Time frame: The Modified Ashworth Scale will be performed at each visit of the study
Change in mean sleep disruption (0-10 NRS) score from baseline to the end of treatment (Part B)
Time frame: Recorded using IVRS daily diary every day
Change in mean spasm frequency (number of spasms per day) from baseline to the end of treatment (Part B).
Time frame: Recorded using the IVRS daily day every day
Subject global impression of change (SGIC) questionnaire
At Visit 2 (i.e. prior to commencing any treatment) subjects were asked to write a brief description of their spasticity caused by multiple sclerosis and how it affected them emotionally, physically and their ability to function with day to day activities. If subjects were unable to write due to disability then the investigator staff could assist as necessary. Prior to answering the Subject global impression of change, subjects were given the description of their spasticity to aid their memory regarding their symptoms at the start of the study. They were then be asked to complete the global impression of change by answering the following question to be rated on a seven-point scale, "Please assess the change in your spasticity due to multiple sclerosis since immediately before receiving the first course of study treatment (Visit 2) using the scale below" with this anchors: Very much worse, Much worse, Minimally worse, No change, Minimally better, Much better, Very much better.
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Time frame: To be completed by the patient at every visit during treatment
Carer Global Impression of Change Questionnaire
Time frame: To be completed by the carer at every visit during the treatment period.