Osoby s RS trpí øadou symptomù vèetnì bolesti, svalové spasticity a køeèí, obtíží s moèo- vým mìchýøem, poruchami spánku apod. Úleva tìchto symptomù zlepšuje kvalitu života pacientù s RS. Mnoho pacientù nemá dostateènou úlevu pøi standardní léèbì. Podáváme pøehled mechanizmu úèinku kanabinoidù v situaci zánìtu v CNS, jak je odvozen ze studií provedených u experimentální autoimunitní encefalomyelitidy, a pøehled studií u pacien- tù s RS, které zpùsobily registraci Sativexu v øadì zemí. Sativex je farmaceutický produkt vyrobený z konopí, urèený k léèbì spasticity a neuropatické bolesti u RS. Obsahuje Δ 9 -tet- rahydrokanabinol (THC) a kanabidiol (CBD) v pomìru 1:1. V nedávné dobì byly uskuteè- nìny 3 klinické studie se Sativexem. Léèba signifikantnì redukovala spasticitu (rezistentní vùèi standardní léèbì) a neuropatické bolesti u pacientù s pokroèilou RS, a to o 30 %. Odpovìï na léèbu pozorovaná bìhem prvních 4 týdnù je užiteèným nástrojem v predikci responzivity. Sativex byl registrován v ÈR 15. 4. 2011 pro léèbu spasticity u RS. .

People with MS suffer from a range of symptoms, including pain, muscle spasticity and spasm, bladder problems, sleep disturbance and other. Eleviating of these symptoms im- prove the quality of life. Many individuals with neuropathic pain and spasticity respond inadequately to current treatment options. We provide an overview of cannabinoid mode of action in the inflammed CNS as observed in experimental autoimmune encephalo- myelitis, and of studies in humans with MS which led to registration of Sativex in many countries Sativex ® is a cannabis-based pharmaceutical product for the treatment of spas- ticity and neuropathic pain due to multiple sclerosis, containing Δ 9 -tetrahydrocannabinol (THC) and cannabidiol (CBD) in a 1:1 ratio. Recently three clinical trials were organized with Sativex. Sativex treatment resulted in a significant reduction in treatment-resistant spasticity and neuropatic pain in subjects with advanced MS. Treated patients improved by 30% compared to placebo. The response observed within the first 4 weeks of treatment appears to be a useful aid to predict responder/non-responder status. Sativex was registe- red in the Czech Republic as a treatment for spasticity in MS patients 15 Apr 2011

Univerzita Karlova Praha 1 lékařská fakulta a Všeobecná fakultní nemocnice Neurologická klinika Centrum pro demyelinizační onemocnění Praha

Cannabinoids in multiple sclerosis

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