Who benefits most from THCCBD spray Learning from clinical experience.
Patients with multiple sclerosis (MS) represent a diverse and heterogeneous population varying in terms of disease type, its severity and variable progressiontime-course, and with regard to the wide range of presenting symptoms. Consequently, detailed experience with individual patients is important to provide examples of therapy to specific patient types. In this article, real-life data from clinical practice showing specific aspects relating to use of 9-delta-tetrahydocannabinol and cannabidiol (THCCBD) oromucosal spray (Sativex®) in patients with moderate to severe spasticity resistant to usual therapy will be presented. Three common clinical scenarios will be considered MS patients with resistance to usual spasticity therapies patients with impairment in MS spasticity symptoms MS patients with relevant impairment in quality of lifeactivities of daily living (QoLADL). These case reports highlight the diverse nature of the MS spasticity population and they show the possible usefulness of THCCBD oromucosal spray in individual patients with moderate to severe spasticity resistant to existing therapies, within the frame of use approved after large clinical trial results. Perhaps the most important finding is the possibility of obtaining relevant improvements in QoLADL in some patients with resistant MS spasticity, allowing them to engage back in physical and social activities.