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UK: Cannabis spray for MS patients refused licence

Sarah Boseley

The Guardian

Saturday 11 Jun 2005

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A cannabis-based medicine which had excited the hopes of many multiple
sclerosis patients has been refused a licence.

Many people with the devastating disease have used cannabis illicitly to
relieve the symptoms, such as spasticity and nerve pain, so there had been
great expectations of the medicine, produced as a nasal spray called
Sativex, which had been undergoing trials for several years.

But the Medicines and Healthcare Products Regulatory Authority announced
that the licence application to treat spasticity filed by GW
Pharmaceuticals, which designed and manufactured the drug, had been turned
down on appeal. The MHRA said there was not enough proof that the drug worked.

"We acknowledge that this decision may cause disappointment to MS patients.
However, there was insufficient evidence to show that the risk-benefit
relationship was favourable," said Kent Woods, the authority's chief executive.

Patient groups were dismayed and the company's chairman, Geoffrey Guy, said
he was "very, very frustrated". He said further trials were under way to
try to obtain the data that would convince the regulator to grant a licence.

The MHRA is satisfied that the drug is safe and of good quality - but it
has fallen at the third hurdle, efficacy.

Dr Guy said his company had won the battle to have patients' reports of
their improvement considered, rather than an assessment of how much better
they were on a disputed clinical scale. But another trial must now be run
to obtain data from larger numbers of patients.

Mike O'Donovan, chief executive of the Multiple Sclerosis Society, said:
"This news will be greeted with dismay by many of the 85,000 people in the
UK who have MS and suffer from distressing symptoms, including spasticity
and pain. How long must they wait? When the society spoke at the Medicines
Commission hearing we stressed that the choice of available treatments was
limited, and many people did not find them effective. It was emphasised
that measurements to assess new treatments for a fluctuating condition like
MS do not always detect significant benefits patients feel.

"We believe there is convincing evidence that cannabis-derived drugs can
significantly improve their quality of life."

Christine Jones, chief executive of the MS Trust, agreed. "It is extremely
frustrating that the prospect of a licensed cannabis-derived medicine is
still no closer," she said.

"Unfortunately neither the Medicines Commission nor the MHRA appears to be
willing to take account of the very positive and statistically significant
feedback from people with MS, who report relief from spasticity."

Sativex has already been given a licence for nerve pain relief in Canada,
although this was conditional on more trials being done. Dr Guy said the
company had a lot of evidence that the drug was effective in pain relief -
but was told to apply for a licence for spasticity by the MHRA, only to be
told that the efficacy data was not sufficient.

He said the drug was very helpful to some people in the trials. "The
investigators see some patients' lives being totally changed beyond
recognition," he said. "There are no other medicines that treat these
patients. All our work was done in patients for whom all other treatment
possibilities had been exhausted."

There are 400 patients in the UK still taking Sativex because they were in
the trials. Other patients may seek to get it from Canada, he said, but
they will need a prescription from a doctor who believes the drug can help,
approval from the MHRA, and an import licence from the Home Office, because
cannabis is a schedule 1 drug.

Dr Guy said he would now push for cannabis to be rescheduled, because
therewas proof that it had a medical use, both from Canada and from the UK
trials. Schedule 1 drugs are defined as having no therapeutic value.

 

 

 

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