Nabiximols oromucosal spray in patients with multiple sclerosis-related bladder dysfunction: A prospective study

Area of Science:

• Neurology
• Urology
• Pharmacology

Background:

• Urinary disturbances and spasticity significantly impact the quality of life for persons with multiple sclerosis (pwMS).
• Cannabis-based medications, like nabiximols oromucosal spray, have shown potential in managing sphincteric disturbances.
• Limited research exists on the instrumental evaluation of nabiximols' effects on urinary issues in pwMS.

Purpose of the Study:

• To assess the efficacy of nabiximols oromucosal spray in improving urinary disturbances in pwMS.
• To evaluate changes in clinical and urodynamic parameters following nabiximols treatment.

Main Methods:

• A longitudinal study involving 31 pwMS treated with nabiximols.
• Clinical assessments included neurological status, spasticity, quality of life (QoL), and the International Prostatic Symptoms Score (IPSS).
• Urodynamic evaluations measured detrusor pressure, bladder capacity, uninhibited detrusor contractions, and post-void residual volume at baseline and at 1 and 6 months.

Main Results:

• Nabiximols significantly reduced IPSS scores and improved QoL from baseline to 6 months.
• Significant improvements were observed in maximum detrusor pressure (Pdet) and bladder filling capacity (CCmax).
• Patients with overactive bladder showed marked urodynamic improvements, particularly in Pdet; spasticity and related symptoms also decreased significantly.

Conclusions:

• Nabiximols oromucosal spray demonstrates a notable effect in alleviating subjective urinary disturbances in pwMS.
• The treatment positively influences objective urodynamic parameters, especially in patients with hyperactive bladder.
• Nabiximols also contributes to reducing spasticity and enhancing the overall quality of life for individuals with multiple sclerosis.