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Nabiximols reduces pain and spasticity in multiple sclerosis patientsNabiximols reduces pain and spasticity in MS patients

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Key Takeaway
Nabiximols significantly reduces pain and spasticity in MS, with modest disability improvement.

A meta-analysis evaluated the efficacy of Sativex (nabiximols) for managing pain, spasticity, and disability in patients with multiple sclerosis (MS). The analysis included studies assessing pain intensity on the Numeric Rating Scale, spasticity severity, and disability via the Expanded Disability Status Scale (EDSS).

Results showed that nabiximols significantly reduced pain intensity compared to control, with a standardized mean change (SMC) of -0.88 (95% CI -1.20 to -0.57, p < 0.0001). Spasticity severity also significantly decreased (SMC -1.29, 95% CI -1.63 to -0.94, p < 0.0001).

Disability improvement was modest but statistically significant (SMC -0.17, 95% CI -0.28 to -0.07, p = 0.0015). These findings suggest that Sativex may be an effective therapeutic option for MS-related pain and spasticity, with potential benefits for functional disability.

Clinicians should note that the disability benefit was modest, and further research is needed to confirm long-term outcomes. No safety data were reported in this meta-analysis.

How this fits prior evidence

This meta-analysis addresses a gap in managing symptomatic manifestations of multiple sclerosis, such as pain and spasticity. While prior coverage has established biomarkers like sNfL for neuroaxonal injury and identified factors influencing MS progression like aging and menopause, this finding specifically addresses the pharmacological management of physical symptoms. It does not directly relate to the reported findings regarding serum neurofilament light chain or the impact of diabetes as a modifier of risk.

A meta-analysis of multiple studies looked at whether Sativex (nabiximols) helps people with multiple sclerosis (MS) manage pain, spasticity, and disability. The analysis combined results from several trials to get a clearer picture of the drug's effects.

Researchers found that Sativex led to a significant reduction in pain intensity, measured on a numeric rating scale. Spasticity severity also dropped significantly. There was a modest but statistically significant improvement in disability, as measured by the Expanded Disability Status Scale.

The analysis did not report on side effects, serious adverse events, or how many people stopped taking the drug. It also did not list any limitations of the studies included. Because this is a meta-analysis, it combines existing data and does not provide new direct evidence from a single trial.

For people with MS, these findings suggest that Sativex may be an effective option for managing pain and spasticity. The benefit for disability was modest, so it should not be expected to dramatically change function. As always, talk to your doctor about whether this treatment is right for you.

What this means for you:
Sativex may help MS patients with pain and spasticity, but disability benefits are modest.

Common questions

What is Sativex (nabiximols)?

Sativex is a mouth spray containing nabiximols, a cannabis-based medicine. It is used to treat symptoms like pain and spasticity in people with multiple sclerosis.

How much does Sativex reduce pain and spasticity?

The analysis found a significant reduction in pain (effect size -0.88) and spasticity (effect size -1.29). These are large effects, meaning many patients experienced noticeable relief.

Does Sativex improve disability in MS?

Yes, but the improvement was modest. The effect size was -0.17, which is small. So while it may help, it is not a major treatment for disability.

Are there side effects with Sativex?

This analysis did not report on side effects or safety. You should ask your doctor about potential risks and side effects before starting Sativex.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
Multiple Sclerosis (MS) is a neurological disorder that commonly begins in young adulthood and impacts central nervous system (CNS) through an autoimmune process. Pain is a frequent and heterogeneous symptom of this disease, but it is often overlooked and inadequately treated. Furthermore, among the most significant clinical manifestations, spasticity, present in 60-84% of MS patients, is not only a major disability factor but also contributes significantly to pain perception and worsening motor function.This systematic review and meta-analysis were conducted to evaluate the available evidence on the efficacy of Sativex® (Nabiximols), not only in pain control but also in the management of spasticity and disability caused by MS.A literature search was conducted on three main databases (PubMed, Scopus, and Web of Science), following the PRISMA guidelines, retrieving 1203 articles, of which 20 met the inclusion criteria and were selected for the systematic review and meta-analysis.Results showed a significant reduction in pain intensity, measured using the Numeric Rating Scale (NRS), after treatment with Sativex® (Standardized Mean Change [SMC]: -0.88, 95% CI -1.20 to -0.57, p < 0.0001). A significant reduction in spasticity severity was also observed (SMC: -1.29, 95% CI -1.63 to -0.94, p < 0.0001). In addition, a modest but statistically significant improvement in disability, assessed by Expanded Disability Status Scale (EDSS), was detected (SMC: -0.17, 95% CI -0.28 to -0.07, p = 0.0015). Overall, evidence suggests that Sativex may represent an effective therapeutic option for the management of pain and spasticity in patients with MS, with potential benefits for functional disability.
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