Current Treatment for Spasticity in Multiple Sclerosis – Satisfaction, Limitations, and Future Directions

Background: Spasticity, a complex and multidimensional symptom of multiple sclerosis (MS), occurs in up to 80% of those with MS. Spasticity can negatively impact many aspects of daily living for people with MS and spasticity (PwMSS), and effective treatment remains a challenge.

Objectives: We sought to characterize how PwMSS manage and treat their symptoms associated with spasticity, and also describe their satisfaction with current treatments and interest in new treatment options.

Methods: SEEN-MSS (Symptoms and Emotions Exploration Needed in Multiple Sclerosis Spasticity), a cross-sectional, online survey, was developed in collaboration with three US-based MS advocacy organizations. The survey included multiple choice and rank order questions and was completed by US-based PwMSS from February to May 2021. Analysis was performed using descriptive statistics.

Results: The survey was completed by 1,177 adult PwMSS (78% female, mean age 56.8 years). Participants reported receiving an MS diagnosis 16.8 years (mean) earlier and experiencing spasticity symptoms for 11.5 years (mean). Overall, 86% of PwMSS are on ≥1 drug treatments for spasticity and only 8% are extremely satisfied with treatment. Over half (53%) of PwMSS use other treatments (stretching, exercise, massage, physical therapy) in addition to drug treatment. One-quarter stopped speaking to their physician about spasticity treatment because they believed that nothing more could be done. Almost half (47%) of PwMSS have tried a cannabis product to treat their MS symptoms (e.g., spasticity and pain) and are more satisfied with medical cannabis than with recreational or CBD/hemp-derived options. Three-quarters were willing to discuss medical cannabis use with their physicians. Most (94%) PwMSS are interested (55% very/extremely interested) in new spasticity treatments, and 87% are interested (57% very/extremely interested) in an FDA-approved cannabis-based treatment for spasticity. FDA approval would improve their comfort with discussing a cannabis-based treatment with clinicians and give them confidence in the drug’s efficacy, safety, and consistency.

Conclusions: This survey highlights that most PwMSS are not satisfied with current treatments for their spasticity. PwMSS are very interested in new products to treat spasticity, particularly an FDA-approved cannabis-based treatment, which would give them confidence in the drug’s efficacy, safety, and consistency and make them more comfortable discussing cannabis-based treatment with their physicians.