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Disclaimer: 'MS Views and News' DOES NOT endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, for your personal knowledge and to keep you informed of current health-related issues. It is not a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.


Thursday, October 5, 2017

Discovering MS Research

October 5, 2017 - By: LAURA KOLACZKOWSKI

When talking about MS research, we tend to focus on drug development because improved therapies, and even the cure for MS, will come from pharmaceuticals. But what do we know about other MS research that doesn’t involve taking a pill or enduring an injection? I’m talking about those research studies that are looking at the activities of daily living (ADL) and quality of life (QoL) studies.
When new research results for a new drug comes out, we are bombarded with press releases and news headlines. After they are approved, we also see those drugs advertised in the various print publications we may get from MS advocacy organizations. Doctors also are hit with that same approach — the drug companies dispatch legions of their sales representatives to visit the neurologists and nurses who treat people with MS. Clinicians hear presentations on these drugs and how they are the newest way to help their patients.

Research: Not just about drugs

But for every drug study being done through clinical trials, I am guessing there are hundreds of other MS studies taking place and producing results we rarely hear about. That brings up a question I recently discussed with my co-principal investigator for iConquerMS, the patient-centered multiple sclerosis research community. Once we have results from studies, how can we get that information back to people affected by MS so they can use the information to improve their lives?

Ideally, when a neurologist is sharing information with their patient, they should be talking about the ways a person’s current situation might be improved, without it involving a drug therapy. What are the latest results from studies on diet? How about information on the importance of vitamin D? Perhaps the latest exercise study gives tips on how to maintain upper limb function for people who are confined to a wheelchair. I could go on and on with this list of examples, but will stop there.

Sharing results

Only half in jest, we talked about how it would be lovely if we had a large number of sales representatives who could carry glossy brochures into an office and disseminate the latest findings of our studies and the results of the many other ADL and QoL studies being done. But there is no funding for that, so we have to rely on the old method of word of mouth, but in a contemporary form. We know the end users of this research knowledge also are the best and most efficient messengers.

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How Laughter Can Help People Living with MS

laughter and multiple sclerosis
Laughing may be a way to a healthier lifestyle for people with neurological diseases.
That was the premise of a recent study that took place in Israel.
Neurological disorders, including multiple sclerosis (MS) and Parkinson’s disease, can cause anxiety and sleep issues, among other symptoms.
The researchers of the study, which focused on people with Parkinson’s, said laughter therapy may be an effective way for people with these conditions to feel better.
There is also a new clinical trial that will study the effects of laughter therapy on people with a variety of neurological disorders, including MS.
Continue reading

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Wednesday, October 4, 2017

Cognitive Impairment, Cerebellar Lesions in MS

Oct 3, 2017

A specific pattern of cerebellar lesions involving the middle cerebellar peduncle (MCP), rather than the total cerebellar white matter lesion (CWML) load, contributes to cognitive dysfunction in relapsing-remitting multiple sclerosis (RRMS), a recent study found. Cerebellar lesion profiles, therefore, may provide a biomarker of current or evolving risk for cognitive status change in RRMS. High-resolution structural magnetic resonance imaging (MRI) was acquired on 16 cognitively impaired (CI) and 15 cognitively preserved (CP) RRMS subjects at 3T and used for lesion identification and voxel-based lesion-symptom mapping (VLSM). Researchers found:

CI RRMS demonstrated a predilection for the MCP.
VLSM results indicate that lesions of the MCP are significantly associated with CI in RRMS.
Measures of cerebellar lesion load were correlated with age at disease onset but not disease duration.

Read More


MS Symptom Severity and Patient-Rated Health

Oct 3, 2017

Pain contributed the most to multiple sclerosis (MS) outpatients’ perception of health, followed by gait dysfunction and fatigue, according to a recent study. These findings suggest that “invisible disability” may be more important to patients’ sense of well-being than physical disability, and challenge the notion that physical disability should be the primary outcome measure in MS. Patients in 2 MS centers assessed self-rated health with a validated instrument and symptom burden with symptoMScreen, a validated battery of Likert scales for 11 domains commonly affected by MS.

Researchers found:

Among 1,865 MS outpatients (68% women, 78% with relapsing–remitting MS, mean age 46.38 ± 12.47 years, disease duration 13.43 ± 10.04 years), average self-rated health score was 2.30 (moderate to good).

Symptom burden (composite symptoMScreen score) highly correlated with self-rated health (r=0.68) as did each of the symptoMScreen domain subscores.

In regression analysis, pain (t=7.00), ambulation (t=6.91), and fatigue (t=5.85) contributed the highest amount of variance in self-rated health.

Read more

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Retinal Differences in Persons with MS Examined

Oct 3, 2017

The largest and most robust differences between the eyes of people with multiple sclerosis (MS) and control eyes were found in the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer and inner plexiform layer (GCIPL), according to a recent study. In this systematic review and meta-analysis, investigators searched for studies in which spectral domain optical coherence tomography (SD-OCT) was used to look at the retina in people with MS with or without optic neuritis in medical literature between November 22, 1991, and April 19, 2016. They found:
  • Of 25,497 records identified, 110 articles were eligible and 40 reported data (in total 5,776 eyes from patients with MS [1,667 MS-associated optic neuritis (MSON) eyes and 4,109 MS without optic neuritis (MSNON) eyes] and 1,697 eyes from healthy controls).
  • Compared with control eyes, the RNFL showed thinning in MSON eyes and in MSNON eyes.
  • The macula showed RNFL thinning of −6·18 μm in MSON eyes and −2·15 μm in MSNON eyes compared with control eyes.
  • Atrophy of the macular GCIPL was −16·42 μm for MSON eyes and −6·31 μm for MSNON eyes compared with control eyes.
Petzold A, Balcer LJ, Calabresi PA, et al. Retinal layer segmentation in multiple sclerosis: A systematic review and meta-analysis. Lancet Neurol. 2017;(16)10:797-812. doi:10.1016/S1474-4422(17)30278-8.
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This is a clinical trial for Patients with Urinary Incontinence, who have Multiple Sclerosis…


If you or a loved one experience MS-related urinary incontinence (UI), or involuntary urine leakage, new options may be available.

Clinical trials help to find new treatments for a variety of conditions, such as UI due to MS, and we would like to let you know about a new trial that is now enrolling.
This trial is testing whether Dysport®, which is already approved for other conditions, can help reduce UI in people living with MS for whom oral medications have not worked well.
You or your loved one may be able to take part if you or he/she:
  • Are between 18 and 80 years of age;
  • Have MS;
  • Have UI due to MS;
  • Have not responded well to oral medications; and
  • Are routinely performing clean intermittent catherization.

To learn more and to see if you or your loved one may be able to take part, please click here.

As you may know, MS Views and News (MSVN) , several months ago, partnered with Antidote, a digital health company, to offer a new clinical trial search tool on our website that will make learning about and connecting with MS clinical trials easier than ever. If this UI trial is not of interest to you, we encourage you to check out the search tool and learn more about other MS-related research trials in your area.

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Antidote is a digital health company that provides access to the latest clinical trials. Antidote’s match tool makes it simple for anyone to search and learn more about condition-specific clinical trials in an effort to make medical research more accessible to everyone.

MS Views and News (MSVN) does not endorse or have any control or relationship with the service being provide

Teva Comments on Anticipated At-Risk U.S. Launch of Generic Glatiramer Acetate 40mg/mL and Launch of Generic Glatiramer Acetate 20mg/mL

JERUSALEM--(BUSINESS WIRE)--Oct. 4, 2017-- Teva Pharmaceutical Industries Ltd.  today commented that any launch by Mylan of a generic version of COPAXONE® 40mg/ml (glatiramer acetate) prior to final resolution of the pending patent appeals and other patent litigation should be considered an “at-risk” launch, which could subject Mylan to significant damages among other remedies. Additionally, Mylan also announced approval of a generic glatiramer acetate 20mg/mL.
“We have planned for the eventual introduction of a generic competitor to glatiramer acetate,” said Dr. Yitzhak Peterburg, Teva’s Interim President and CEO. “We remain confident in patient and physician loyalty to Teva’s COPAXONE® due to its recognized efficacy, safety and tolerability profile, and we will continue to promote and support the product. As we are closing the third quarter, it is too soon to officially comment on any change to our full year business outlook.”
Two appeals will be argued before a single panel of judges of the U.S. Court of Appeals for the Federal Circuit. In the first case, Teva is appealing the December 2016 inter partes review decisions of the Patent Trial Appeal Board that found all of the claims of three COPAXONE® patents to be unpatentable. In the second case, Teva is appealing the January 2017 decision of the U.S. District Court for the District of Delaware, which declared certain claims of four COPAXONE® patents invalid. The two appeals have been fully briefed and await the scheduling of oral arguments. In additional litigation, Teva brought suit against five Abbreviated New Drug Application (ANDA) filers, including Mylan, for infringement of a patent covering a manufacturing process for glatiramer acetate product.
Due to the anticipated launch of another generic 20mg glatiramer acetate product and the anticipated launch of a first generic 40mg glatiramer acetate product, Teva’s early assessment of the impact of these launches to its earnings for the fourth quarter ended December 31, 2017 is that it could be affected by at least $0.25 cents per share. These conditions are subject to change based on the discount; adoption rate; and other factors of the competitive products. Teva will provide additional details on its 3rd Quarter Earnings Conference Call on November 2, 2017.
About Teva
Teva Pharmaceutical Industries Ltd. (NYSE and TASE: TEVA) is a leading global pharmaceutical company that delivers high-quality, patient-centric healthcare solutions used by approximately 200 million patients in over 60 markets every day. Headquartered in Israel, Teva is the world’s largest generic medicines producer, leveraging its portfolio of more than 1,800 molecules to produce a wide range of generic products in nearly every therapeutic area. In specialty medicines, Teva has the world-leading innovative treatment for multiple sclerosis as well as late-stage development programs for other disorders of the central nervous system, including movement disorders, migraine, pain and neurodegenerative conditions, as well as a broad portfolio of respiratory products. Teva is leveraging its generics and specialty capabilities in order to seek new ways of addressing unmet patient needs by combining drug development with devices, services and technologies. Teva's net revenues in 2016 were $21.9 billion.  For more information, visit www.tevapharm.com.

Cautionary Note Regarding Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, which are based on management’s current beliefs and expectations and are subject to substantial risks and uncertainties, both known and unknown, that could cause our future results, performance or achievements to differ significantly from that expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to:
  • Copaxone®, our leading medicine, which faces competition from existing and potential additional generic versions and orally-administered alternatives and the effectiveness of our patents and other measures to protect its intellectual property rights;
  • our specialty medicines business, including: our ability to achieve expected results from investments in our product pipeline; competition for our specialty products including competition from companies with greater resources and capabilities; and our ability to protect our intellectual property rights;
  • our generics medicines business, including: that we are substantially more dependent on this business, with its significant attendant risks, following our acquisition of Allergan plc’s worldwide generic pharmaceuticals business (“Actavis Generics”); our ability to realize the anticipated benefits of the acquisition (and any delay in realizing those benefits) or difficulties in integrating Actavis Generics; the increase in the number of competitors targeting generic opportunities and seeking U.S. market exclusivity for generic versions of significant products; price erosion relating to our generic products, both from competing products and as a result of increased governmental pricing pressures; and our ability to take advantage of high-value biosimilar opportunities;
  • our substantially increased indebtedness and significantly decreased cash on hand, which may limit our ability to incur additional indebtedness, engage in additional transactions or make new investments, and may result in a downgrade of our credit ratings;
  • our business and operations in general, including: uncertainties relating to our recent senior management changes; our ability to develop and commercialize additional pharmaceutical products; manufacturing or quality control problems, which may damage our reputation for quality production and require costly remediation; interruptions in our supply chain; disruptions of our or third party information technology systems or breaches of our data security; the failure to recruit or retain key personnel, including those who joined us as part of the Actavis Generics acquisition; the restructuring of our manufacturing network, including potential related labor unrest; the impact of continuing consolidation of our distributors and customers; variations in patent laws that may adversely affect our ability to manufacture our products; our ability to consummate dispositions on terms acceptable to us; adverse effects of political or economic instability, major hostilities or terrorism on our significant worldwide operations; and our ability to successfully bid for suitable acquisition targets or licensing opportunities, or to consummate and integrate acquisitions;
  • compliance, regulatory and litigation matters, including: costs and delays resulting from the extensive governmental regulation to which we are subject; the effects of reforms in healthcare regulation and reductions in pharmaceutical pricing, reimbursement and coverage; potential additional adverse consequences following our resolution with the U.S. government of our FCPA investigation; governmental investigations into sales and marketing practices; potential liability for sales of generic products prior to a final resolution of outstanding patent litigation; product liability claims; increased government scrutiny of our patent settlement agreements; failure to comply with complex Medicare and Medicaid reporting and payment obligations; and environmental risks;
  • other financial and economic risks, including: our exposure to currency fluctuations and restrictions as well as credit risks; the significant increase in our intangible assets, which may result in additional substantial impairment charges; potentially significant increases in tax liabilities; and the effect on our overall effective tax rate of the termination or expiration of governmental programs or tax benefits, or of a change in our business;
and other factors discussed in our Annual Report on Form 20-F for the year ended December 31, 2016 (“Annual Report”), including in the section captioned “Risk Factors,” and in our other filings with the U.S. Securities and Exchange Commission, which are available at www.sec.gov and www.tevapharm.com. Forward-looking statements speak only as of the date on which they are made, and we assume no obligation to update or revise any forward-looking statements or other information contained herein, whether as a result of new information, future events or otherwise. You are cautioned not to put undue reliance on these forward-looking statements.


Two Cytokines Linked to MS Disease Progression

OCTOBER 03, 2017
Jared Kaltwasser

Scientists have identified 2 cytokines that appear to be tied to the potential for a patient’s multiple sclerosis (MS) to progress to a more severe form.

The cytokines — macrophage migration inhibitory factor (MIF) and D-dopachrome tautomerase (D-DT) — have already been known to be involved in exacerbating other autoimmune disorders by increasing inflammation.

The question for researchers at Oregon Health and Science University and Yale University was whether any correlation could be found between those 2 immunoregulatory cytokines and MS progression specifically.

Through a mix of clinical observation and immunologic and DNA analysis, the researchers found that MIF and D-DT levels were indeed higher in patients with progressive disease. They also demonstrated that male patients who are genetically prone to higher levels of MIF had a greater chance of having progressive MS.

“These findings indicate that genetically controlled high MIF expression (and D-DT) promotes MS progression in males,” researchers wrote, “suggesting that these two factors are sex-specific disease modifiers and raising the possibility that aggressive anti-MIF treatment of clinically isolated syndrome or RRMS males with a high-expresser genotype might slow or prevent the onset of progressive MS.”

The findings also pave the way for simple genetic testing to be used to help identify patients at risk of developing the more severe form of the disease.

Arthur A. Vandenbark, PhD, told MD Magazine that it makes sense that the link would be evident in males. Though women are about 3 times as likely to be diagnosed with MS, cases of MS in men tend to have more severe cases, on average.

“My theory, based on some data in the mouse model of MS, is that females may have less severe progressive MS than males due to the natural immune inhibitory properties of estrogen that may partially ameliorate MS severity and potentially limit some of the more severe MIF and D-DT effects seen in males,” Vandenbark said.

The researchers also took the first steps to probe the therapeutic implications of their findings. They used an existing therapy targeting MIF models to treat rodents with an MS-like disease.

The treatment succeeded in inhibiting MIF and D-DT, suggesting that it could succeed in slowing or blocking MS progression in humans. The success of the existing therapy is good news for patients, even as scientists work to develop more therapies aimed at reducing MIF and D-DT.

The researchers say therapies targeting CD74, the common receptor for MIF and D-DT, would likely be beneficial in reducing the severity of MS in patients.

The study showed the therapy could work both before and after the onset of acute disease when MIF levels are lower, and during the chronic phase when MIF levels are low or high, Vandenbark said.

“We thus anticipate that blocking effects of MIF and D-DT will be beneficial for patients in all stages of MS, including those who are less likely to develop progressive MS,” Vandenbark said.

The study, “MIF and D-DT are potential disease severity modifiers in male MS subjects,” was published online in the journal PNAS.


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Monday, October 2, 2017

DEA Clarifies Marijuana Extract Rule and CBD Legality

As many of you are aware, on December 14, 2016 the DEA implemented a rule regarding CBD and marijuana extract called the “Final Rule establishing a new Controlled Substance Code Number (drug code) for marijuana extract” (the Rule). Among other things, the Rule claimed that cannabidiol (CBD) and other cannabinoids were part of the newly established drug code and, consequently, were Schedule 1 substances under the Controlled Substances Act (CSA). Schedule 1 is the most restrictive class of drugs and is reserved for drugs that have “no currently accepted medical treatment use” and a “high potential for abuse.” I wrote about the wrongheadedness of the Rule here and focused my attention on the fact that the DEA purported to make illegal something (ie, CBD) that was never illegal in the first place. CBD has never been listed as a controlled substance on the CSA. Importantly, CBD can be sourced from legal plants. I argued that the DEA had overstepped its authority. For this very reason, the DEA is currently a defendant in a lawsuit filed in the 9th Circuit. We expect that suit to go well.
Today, the DEA backed off of its position somewhat. Importantly, it acknowledged that CBD is legal if it comes from a part of the cannabis plant that is itself legal, such as the mature stalk of the cannabis plant, which is excluded from the CSA’s definition of marijuana. In other words, the DEA finally admitted that CBD is not illegal in and of itself; rather, it is legal (or not) based on its source. I’ve been preaching this for a long time, but I have to admit that it’s strange to be validated in the form of an an official DEA clarification!
Here’s what the DEA said: “The new drug code (7350) established in [the Rule] does not include materials or products that are excluded from the definition of marijuana set forth in the Controlled Substances Act (CSA). The new drug code includes only those extracts that fall within the CSA definition of marijuana. If a product consisted solely of parts of the cannabis plant excluded from the CSA definition of marijuana, such product would not be included in the new drug code (7350) or in the drug code for marijuana (7360).
This is important. It is the first time that the Federal government has explicitly stated that cannabinoids (aside from THC which is separately scheduled) are not in and of themselves illegal substances. Most importantly, the DEA tacitly acknowledged that CBD sourced from industrial hemp cultivated lawfully pursuant to a State’s industrial hemp laws enacted under the 2014 US Farm Bill is legal. This is because “industrial hemp” is itself specifically excluded from the CSA’s definition of marijuana in Section 7606 of the Farm Bill. Since industrial hemp is excluded from the definition of the CSA, and a “product consist[ing] solely of parts of the cannabis plant excluded from the CSA definition of marijuana” is not included in the new drug code, then such product (in our case, CBD) is also excluded from the definition of marijuana under the CSA and is thus legal, at least at the Federal level. (Whether or not CBD can be made illegal at the individual state level is another question altogether which I’ll address in an upcoming post.)
None of this is new. But it is good to get some clarification from the DEA.
Rod Kight is a lawyer based in Asheville, NC. He is licensed in North Carolina and Oregon and represents legal cannabis businesses. You can contact him by clicking here.
Posted 3-14-2017.

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Long-term Lemtrada Treatment Benefits Demonstrated in Extension Study

October 2, 2017

A five-year study demonstrated that Sanofi-Genzyme’s Lemtrada(alemtuzumab) provides long-term benefits for relapsing-remitting multiple sclerosis patients, reducing relapse rates and preventing the progression of the disease.
Importantly, most patients required only the standard two-phase treatment course. Few needed additional courses because of relapse or new brain lesions.
The study, “Alemtuzumab CARE-MS I 5-year follow-up,” looked at data from the CARE-MS I Phase 3 clinical trial (NCT00530348) and its extension (NCT00930553), which followed patients for up to five years.
The vast majority, 95.1 percent, of the 367 patients treated in the initial study continued in the extension trial, with 96 percent of these remaining for its entire length of five years. The results were published in the journal Neurology.
The Phase 3 Lemtrada treatment consisted of 12 mg for five consecutive days at the start of the study and three consecutive days a year later. Researchers said 68.5 percent of the patients did not require further treatment in the extension study.
Among those who needed additional treatment, 70 percent had one additional treatment course, and about one-fourth had two. Only 4.5 percent required three additional courses.
Annualized relapse rates were low. They were 0.18 in the first two years, and ranged from 0.19 to 0.14 in the next three.   - Continue reading

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MS Patients with Poor Diets, Little Exercise Report Higher Pain Levels in Study

Oct 2, 2017

MS Patients with Poor Diets, Little Exercise Report Higher Pain Levels in Study

A clear association was seen between the substantial pain that multiple sclerosis (MS) patients experience and lifestyle choices that either augment or ease that pain, like smoking habits, exercise, and diet and weight, researchers in Australia report.
Common co-morbidities associated with MS, such as depression, anxiety, and fatigue, were also seen to hamper efforts to start or maintain healthy behaviors.
Led by researchers at the University of Melbourne, the work aimed to determine associations between moderate-to-severe pain caused by MS — including headaches, lower back pain, neuropathic pain and painful spasms — and lifestyle and co-morbidity factors that impact the disease in a large international cohort of patients.
The team recruited online 2,362 participants, age 18 and older, with a confirmed MS diagnosis. Participants were from all over the world, but in greater concentrations from English-speaking countries. The online survey collected 2012 data from patients, and the team used statistic tools to analyze the information gathered.
Researchers found that more than a fourth of the participants (28.9%) reported moderate to severe pain that interfered with work, household or enjoyment of life in the four weeks prior to the survey. -- Continue Reading

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Combating Muscle Weakness Associated with MS

Combating Muscle Weakness Associated with MS

Sometimes walking, even with an assistance device, can be very challenging because of the extreme muscle weakness that I experience. The slow, off-balanced gait that has been my constant companion for many years prior to my 2010 multiple sclerosis (MS) diagnosis is definitely on the decline.
Accepting the downward progression with MS is not an easy task. Most of the time I live in denial about my ever-changing MS symptoms. Yet, In the back of my mind, I am increasingly made aware of the decreased power my body is experiencing.
Even though it is the increased weakness in my legs that stands out the most to me, the irony is that my arms and hands appear to be getting stronger. It was my husband who brought this to my attention. I was rubbing his back one day when he noticed I massaged with more strength than ever before.
I feel the strength in my arms and hands comes from the pressure I have been applying on my walker. In my mind, since my legs are growing weaker, I am overcompensating with my hands and arms to help me walk. Although the added pressure put on my walker handgrips makes my upper extremities ache, it is apparent they are becoming stronger.
This realization led me to search the internet for help with my weak legs. If applied pressure and added use of my extremities could increase strength in my hands and arms, couldn’t it do the same for my legs?
An article about different MS symptoms from the National Multiple Sclerosis Society (NMSS) titled, “Weakness,” states that muscle weakness is common with MS and that the first step in treating the weakness is to find the cause.
The article adds that the symptoms associated with MS, such as fatigue, mobility issues, and imbalance, can make it very hard to stay active. Both inactivity and underuse of muscles can contribute to muscle weakness for those with MS and for those without it.
A physical therapist can recommend a resistance weight training program to coordinate with your physical abilities for this type of weakness caused by lack of muscle use.
Another cause of muscle weakness is demyelination. In MS, the myelin around the nerves wears away, leaving exposed nerves. The connection then malfunctions and there are no longer stable conductors between the brain and nerves, which help signal the muscles how to work. If there is a short in the communication connection, it can cause the muscle weakness.  -- Continue Reading

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Cannabis Compounds Ease Spasticity in MS, National Academies’ Report States

January 17, 2017

Cannabis Compounds Ease Spasticity in MS, National Academies’ Report States

Certain cannabinoids reduce spasticity symptoms in multiple sclerosis (MS) patients, according to a report  from The National Academies of Sciences, Engineering, and Medicine that scrutinized published research about the benefits and hazards of cannabis and cannabinoid use.
Cannabinoids also show proven effect in other areas that may be important to MS patients, but they are linked to a number of health risks.
The report, titled The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research,” underscored that more research is needed to better understand the health and side effects of cannabis and cannabinoids, and that a number of current challenges make it difficult to reach these research objectives. The report was published by the National Academies Press.
“For years the landscape of marijuana use has been rapidly shifting as more and more states are legalizing cannabis for the treatment of medical conditions and recreational use,” Marie McCormick, committee chairwoman, said in a press release. “This growing acceptance, accessibility, and use of cannabis and its derivatives have raised important public health concerns. Moreover, the lack of any aggregated knowledge of cannabis-related health effects has led to uncertainty about what, if any, are the harms or benefits from its use.
The committee examined research published since 1999, including more than 10,000 scientific abstracts to reach its reported conclusions, almost 100 of them. Studies included the use of both recreational and medical cannabis, and considered the use of cannabinoids — natural or man-made compounds acting at the same receptor as cannabis.   Continue Reading

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