{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:00:16Z","timestamp":1790622016215,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This work aimed to evaluate the efficacy and safety of cannabinoids for the treatment of MS\u2010related spasticity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Systematic searches were conducted in PubMed, EMBASE, and LILACS on 2 December 2025. Randomized controlled trials evaluating natural or synthetic cannabinoids for MS\u2010related spasticity were included. Studies published in non\u2010Roman characters and those assessing recreational cannabis use were excluded. Two reviewers independently performed study selection, data extraction, and risk of bias assessment using the RoB 2 tool. Qualitative synthesis, pairwise random\u2010effects meta\u2010analyses, and Bayesian network meta\u2010analysis were conducted. Certainty of evidence was assessed using GRADE and CINeMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010seven studies (&gt;3000 participants) were included. Interventions comprised\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.guidetopharmacology.org\/GRAC\/LigandDisplayForward?ligandId=2424\">tetrahydrocannabinol<\/jats:ext-link>\n                      :\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.guidetopharmacology.org\/GRAC\/LigandDisplayForward?ligandId=4150\">cannabidiol<\/jats:ext-link>\n                      (THC:CBD) extracts, other cannabis extracts, isolated cannabinoids (natural or synthetic), and smoked cannabis. In pairwise meta\u2010analysis (7 studies), THC:CBD extracts reduced patient\u2010reported spasticity versus placebo (MD \u22120.82; 95% CI \u22121.24 to \u22120.40;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200953%). Network meta\u2010analysis confirmed superiority of THC:CBD (MD \u22120.80; 95% CrI \u22121.61 to \u22120.32). Adverse events were frequent but mostly mild to moderate, while serious events were rare. Certainty of evidence was low, and substantial clinical and methodological heterogeneity was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cannabinoids provide modest improvements in patient\u2010reported spasticity in MS, with more consistent effects for THC:CBD extracts. Given the low certainty of evidence and limited objective benefits, cannabinoids should be considered cautiously as adjunctive therapy with appropriate safety monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70719","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:23:45Z","timestamp":1785734625000},"page":"3288-3300","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of cannabinoids in the treatment of spasticity in multiple sclerosis: A systematic review of randomized clinical trials"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3868-1724","authenticated-orcid":false,"given":"Let\u00edcia","family":"Hamm\u2010Buiar","sequence":"first","affiliation":[{"name":"Federal University of Paran\u00e1 (Universidade Federal do Paran\u00e1)  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5569-6588","authenticated-orcid":false,"given":"Daniela","family":"Gorski","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1 (Universidade Federal do Paran\u00e1)  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2335-5802","authenticated-orcid":false,"given":"Marcela Harumi","family":"Kagueiama","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1 (Universidade Federal do Paran\u00e1)  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4460-4044","authenticated-orcid":false,"given":"Astrid","family":"Wiens","sequence":"additional","affiliation":[{"name":"Federal University of Paran\u00e1 (Universidade Federal do Paran\u00e1)  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/354906"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010018\u20108759\u20101"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(18)30443\u20105"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910\u2010019\u20100991\u20102"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/1658\u2010354X.121087"},{"key":"e_1_2_10_7_1","unstructured":"Cannabis\u2010based medicinal productsEvidence review for spasticity NICE guideline NG144.2019;"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/can.2022.0254"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458516643600"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.13211"},{"key":"e_1_2_10_11_1","volume-title":"Nutzenbewertungsverfahren zum Wirkstoff Extrakt aus Cannabis Sativa (Neubewertung nach Fristablauf: Spastik bei Multiple Sklerose)"},{"key":"e_1_2_10_12_1","unstructured":"BaumhacklUBergerTEnzingerC\u00d6MSB \u00d6sterreichische Multiple Sklerose Bibliothek Evidenzbasierte Informationen zu allen Aspekten der MS f\u00fcr Betroffene sowie \u00c4rzte und \u00c4rztinnen und Angeh\u00f6rige medizinischer Gesundheitsberufe2020Available from:https:\/\/www.facultas.at\/item\/63518207"},{"key":"e_1_2_10_13_1","unstructured":"Generelt om behandling af MS\u2014symptomatisk\u2014NNBV. 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