{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:38:59Z","timestamp":1793392739326,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Nabiximols is a therapeutic option for patients with multiple sclerosis (MS) spasticity whose symptoms are poorly controlled by conventional oral first\u2010line medications. This study aimed to assess the relationship between changes in spasticity severity (measured on the 0\u201310 numeric rating scale [NRS]) and the presence of associated symptoms in patients treated with nabiximols, and to investigate the presence of the newly described \u2018spasticity\u2010plus syndrome\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed real\u2010world data from the Italian Medicines Agency e\u2010Registry on 1138 patients with MS spasticity who began treatment with nabiximols. Evaluation time points were baseline, 4\u2009weeks, and 3, 6, 12 and 18\u2009months after treatment start.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Common symptoms associated with MS spasticity in this cohort were pain (38.4% at baseline), sleep disturbances (32.7%), and spasms\/cramps (28.5%). Pain was frequently clustered with sleep disturbances (57.2% of pain cases) and spasms\/cramps (43.9%). Approximately one\u2010third of patients with data at all evaluation time points maintained treatment at 18\u2009months. Nabiximols reduced the baseline mean spasticity 0\u201310 NRS score by 24.6% at Week 4, and by 33.9% at 18\u2009months in treatment continuers. Nabiximols resolved a range of MS spasticity\u2010associated symptoms at Week 4, and after 18\u2009months in treatment continuers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This real\u2010world analysis supports the concept of a spasticity\u2010plus syndrome and suggests that nabiximols can favorably impact a range of spasticity\u2010associated symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15412","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T04:41:17Z","timestamp":1653021677000},"page":"2744-2753","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["A real\u2010world evidence study of nabiximols in multiple sclerosis patients with resistant spasticity: Analysis in relation to the newly described \u2018spasticity\u2010plus syndrome\u2019"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6923-0846","authenticated-orcid":false,"given":"Francesco","family":"Patti","sequence":"first","affiliation":[{"name":"Section of Neurosciences, Department \u201cGF Ingrassia\u201d University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1607-543X","authenticated-orcid":false,"given":"Clara Grazia","family":"Chisari","sequence":"additional","affiliation":[{"name":"Section of Neurosciences, Department \u201cGF Ingrassia\u201d University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3696-789X","authenticated-orcid":false,"given":"\u00d3scar","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medicine, Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital University of Malaga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Sarroca","sequence":"additional","affiliation":[{"name":"Medical Department Almirall S.A.  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