THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study.

Area of Science:

• Neurology
• Urology
• Pharmacology

Background:

• Lower urinary tract dysfunctions (LUTDs) are prevalent in multiple sclerosis (MS) patients, often manifesting as neurogenic overactive bladder (OAB).
• Managing resistant OAB in MS requires effective therapeutic strategies.
• Cannabinoid-based treatments are being explored for neurological conditions.

Purpose of the Study:

• To evaluate the efficacy of a tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray in treating resistant OAB in MS patients.
• To assess the impact of THC/CBD on clinical OAB symptoms and urodynamic parameters.
• To investigate the effect of THC/CBD on spasticity and mobility in MS patients.

Main Methods:

• An observational study involving 15 MS patients with resistant OAB.
• Patients received THC/CBD oromucosal spray for 4 weeks.
• Clinical assessments included the Overactive Bladder Symptom Score (OABSS), while urodynamic assessments measured parameters like maximal cystometric capacity (CCmax) and post-void residual volume (PVR).
• Neurological and mobility assessments (Modified Ashworth Scale, 25-ft walking-time test) were also conducted.

Main Results:

• THC/CBD treatment significantly reduced OAB symptoms (p=0.001).
• Post-treatment, post-void residual volume (PVR) was significantly reduced (p=0.016).
• Bladder volume at first desire (BVFD) and CCmax showed non-significant increases.

Conclusions:

• THC/CBD oromucosal spray demonstrates effectiveness in alleviating overactive bladder symptoms in MS patients.
• The treatment positively impacts detrusor overactivity and urodynamic function.
• THC/CBD offers a potential therapeutic option for managing neurogenic OAB in the context of multiple sclerosis.