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Safety and tolerability of nabiximols oromucosal spray: a review of more than 15 years" accumulated evidence from clinical trials.

Abstract
Introduction: Nabiximols, a cannabinoid-based oromucosal spray, is indicated as add-on therapy for symptomatic relief of spasticity in persons with multiple sclerosis (MS). This review compiles tolerability and safety data from clinical trials that investigated nabiximols for spasticity and/or chronic pain.Areas covered: Systematic searches identified 38 placebo-controlled randomized controlled trials (RCTs) or post-RCT open-label studies reporting safety data: 15 in spasticity; 16 in neuropathic pain; six in chronic cancer pain; and one in rheumatoid arthritis pain. In RCTs, discontinuation rates due to adverse events (AEs) for nabiximols and placebo were lower in spasticity studies (5.4% and 2.8%) than in neuropathic pain (12.9% and 5.3%) or cancer pain (19.5% and 16.6%) studies. The most consistently identified AEs were dizziness, nausea and fatigue in spasticity or neuropathic pain studies; and dizziness, nausea, vomiting and somnolence in cancer pain studies. Serious AE (SAE) rates for nabiximols and placebo were higher in cancer pain (21.8% and 16.9%) than in MS spasticity (4.7% vs. 0.8%) and neuropathic pain (4.1% vs. 3.1%) studies despite similar dose ranges. Treatment-related SAEs showed no particular pattern.Expert opinion: More than 15 years of investigation of nabiximols oromucosal spray in spasticity and chronic pain conditions indicates an acceptable overall safety profile.
AuthorsJosé María Prieto González, Carlos Vila Silván
JournalExpert review of neurotherapeutics (Expert Rev Neurother) Vol. 21 Issue 7 Pg. 755-778 (07 2021) ISSN: 1744-8360 [Electronic] England
PMID34092180 (Publication Type: Journal Article, Review)
Chemical References
  • Drug Combinations
  • Cannabidiol
  • Dronabinol
  • nabiximols
Topics
  • Cannabidiol (adverse effects)
  • Dronabinol (adverse effects)
  • Drug Combinations
  • Humans
  • Multiple Sclerosis (drug therapy)
  • Muscle Spasticity (drug therapy)
  • Neuralgia (drug therapy)

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