Beware the power of placebo

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Beware the power of placebo

Postby dignan » Wed Nov 09, 2005 2:22 pm

My favorite part of the article about Sativex below, "Three patients (11 percent) withdrew from the placebo group after experiencing adverse events they associated with treatment."

I think this is promising because they also noticed a reduction in relapses in one of the the MS trials they did for Sativex, although the trial wasn't designed to look at relapses and the numbers were too small to draw firm conclusions. This is actually a case where I hope the researchers use Bromley's favorite conclusion and say more study is required. I'm not sure if they are considering Sativex for any additional MS trials.



Cannabis drug promising in rheumatoid arthritis

Nov 9, 2005 - Reuters Health - A company-sponsored trial of GW Pharma's cannabis-based medicine, Sativex, in rheumatoid arthritis patients, shows the drug works as a painkiller and may also slow disease progression, according to research published online in Rheumatology on Wednesday.

In the first ever controlled trial of a cannabis-based medicine (CBM) in rheumatoid arthritis, significant pain-relieving effects were observed and disease activity was significantly suppressed following Sativex treatment, according to researchers

"Whilst the differences are small and variable across the population, they represent benefits of clinical relevance and show the need for more detailed investigation in this indication", researchers led by the Royal National Hospital for Rheumatic Diseases, in Bath, England concluded.

Of the 56 patients in the five-week randomized study, 31 were given Sativex daily by fixed delivery oromucosal spray and 27 received placebo.

Each spray of Sativex delivers Tetrahydrocannabinol (2.7mg) and cannabidiol (2.5mg).

Assessment of pain on movement, pain at rest, morning stiffness and sleep quality was measured using a numerical scale, the Short-Form McGill Pain Questionnaire (SF-MPQ) and the DAS28 measure of disease activity.

The cannabis-based drug produced statistically significant improvements in pain of movement, pain at rest, quality of sleep, and disease activity.

Co-author Philip Robson, Director of Cannaboid Research Institute, Oxford told APM: "It's a preliminary study but you would have to say it's a promising start. Pain relief was over and above the standard treatment already being taken in a stabilized way.

The so-called DAS scale is supposed to reflect the inflammatory effect of the disease and this improvement might suggest that the drug is affecting the process of the disease, "although this remains very speculative," Robson added.

The large majority of side effects were mild or moderate and the treatment group showed no serious adverse effects or withdrawals due to side effects.

Three patients (11 percent) withdrew from the placebo group after experiencing adverse events they associated with treatment.

Adverse events reported with CBM included mild dizziness, light-headedness, and dry mouth.

The study was funded by GW pharmaceuticals, which with Bayer, has launched Sativex for multiple sclerosis patients in Canada but which has so far failed to secure marketing authorization in Europe.
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Re: Beware the power of placebo

Postby HarryZ » Thu Nov 10, 2005 7:03 am

Dignan,

Interesting info on the placebo patients.

My wife (SPMS) has been using Sativex for about 5 months now. She does not use it on a continuous basis but when she has more than the normal pain from her spasms. In most cases, the Sativex relieves her overall pain within 15-25 minutes after taking it. It does reduce the spasm activity but does not prevent the deep, heavy-duty spasms that have plagued her for the past 4 1/2 years. It does allow her to get some much needed sleep by reducing the pain level and allowing her to relax some. There have not been any side effects to date.

Harry
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Postby dignan » Thu Nov 10, 2005 8:09 am

Sounds like it is quite effective. Was your wife taking anything for her spasms before Sativex and if so, does Sativex work significantly better?
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Postby HarryZ » Thu Nov 10, 2005 9:00 am

dignan wrote:Sounds like it is quite effective. Was your wife taking anything for her spasms before Sativex and if so, does Sativex work significantly better?


No she wasn't. Marg was trying various kinds of physiotherapy to try and relieve the spasms caused by her severely broken leg of 4 1/2 years ago. Prior to that, spasms were not a problem at all.

As she was trying the physio, her neuro did not suggest meds like baclofen because he stated it would make her legs too weak. She really wanted to have the ability to take a step or two or at least transfer from her wheel-chair on her own. As usual with MS, if you fix one problem, another one seems to replace it.

We are now going to have her seen at the pain clinic here and hopefully they will be able to come up with some ideas.

Harry
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Postby fightingms » Fri Nov 11, 2005 5:22 am

As usual with MS, if you fix one problem, another one seems to replace it.

So true.........I hope your wife is doing better, and I will pray for her.

You know while I was in Florida visiting family in May, I tried the real thing.

I Kept hearing how it controlls pain and stiffness. They were right one or two puffs was all it took. Not enough to get high, but enough to control the nightime stiffness and pain, and help you sleep.

I didn't even take my nighttime meds on those 2 nights of my experiment.

I have two children, one 16 and one in college. SO...I havn't tried it since.

Like they say they can give us moriphine patches.......but don't say the M word and everyone goes crazy. I will be keping my eye on this to see how it goes. A spray would be easier to explaine to a 16yr. okd :D

Take care and hello to your wife. Hope her days get better.....Kim
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Postby fightingms » Fri Nov 11, 2005 5:23 am

Thanks for the article........Kim
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Postby dignan » Fri Nov 11, 2005 9:35 am

I hope the pain clinic can offer some relief.
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Postby HarryZ » Fri Nov 11, 2005 10:38 am

Dignan,

dignan wrote:I hope the pain clinic can offer some relief.


I'll let you know what happens. They did call after receiving the referral from Marg's neuro but said they would call back with an appointment date. Have no idea how long it will take.

Harry
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