{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:38:57Z","timestamp":1793392737006,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T00:00:00Z","timestamp":1679184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Randomized controlled trials and observational studies of nabiximols oromucosal spray in patients with multiple sclerosis (MS) spasticity have shown improvement in a range of associated symptoms (pain, spasms, fatigue, bladder dysfunction, and sleep disturbances). This study evaluated the effectiveness and tolerability of add\u2010on nabiximols in the routine management of patients with MS spasticity in Austria, with a focus on spasticity\u2010associated symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an open, prospective, multicenter, observational, non\u2010interventional study of patients with MS spasticity receiving add\u2010on treatment with nabiximols oromucosal spray. Main endpoints were patient\u2010reported changes from baseline in the frequency (counts) or severity (mean Numerical Rating Scale [NRS] scores) of spasticity\u2010associated symptoms, and patient\u2010reported changes from baseline in impairment of daily activities due to spasticity, after 1 and 3 months of nabiximols treatment. No analyses were conducted for statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 55 patients in the effectiveness population, and 62 in the safety population. Patients reported clinically relevant reductions from baseline to month 3 in the average number of spasms\/day (\u221268.2%) and number of urinary incontinence episodes (\u221269.3%) in the week prior to the clinic visit, and reductions in mean 0\u221210 NRS scores for sleep impairment (\u221247.2%), fatigue (\u221226.4%), pain (40.4%), and spasticity severity (39.0%). There was no change from baseline in daily activity impairment due to spasticity. The majority of patients were at least partly satisfied with add\u2010on nabiximols for spasticity\u2010associated symptoms. There were 31 adverse events (27 treatment related) reported in 19 patients, with no new safety signals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Add\u2010on nabiximols improved the severity of MS spasticity and a range of spasticity\u2010associated symptoms during real\u2010world use in Austria. Nabiximols is an option for patients with MS spasticity who fail first\u2010line oral antispasticity treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.2947","type":"journal-article","created":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T15:38:45Z","timestamp":1679240325000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Non\u2010interventional, prospective, observational study on spasticity\u2010associated symptom control with nabiximols as add\u2010on therapy in patients with multiple sclerosis spasticity in Austria"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8219-781X","authenticated-orcid":false,"given":"Michael","family":"Guger","sequence":"first","affiliation":[{"name":"Department of Neurology Pyhrn\u2010Eisenwurzen Klinikum Steyr  Steyr Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hatschenberger","sequence":"additional","affiliation":[{"name":"Department of Neurology Klinikum Bad Hall and Bad Schallerbach  Bad Schallerbach Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fritz","family":"Leutmezer","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/00207454.2013.812084"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0575"},{"key":"e_1_2_11_4_1","unstructured":"Bundesamt f\u00fcr Sicherheit im Gesundheitswesen. (2018).Wissenschaftlicher Leitfaden zur Durchf\u00fchrung von Nicht\u2010interventionellen Studien (NIS) in \u00d6sterreich. Aktualisiert.https:\/\/www.jku.at\/fileadmin\/gruppen\/88\/L_I212_Leitfaden_NIS_AT.pdf"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2217\/nmt\u20102022\u20100002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000520560"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.102805"},{"key":"e_1_2_11_8_1","unstructured":"eMC. Sativex Oromucosal Spray. SmPC. 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