Authors: Alice Bough, Future Science Group
New guidelines published by NICE have led to NHS England approving two cannabis-based medications for the treatment of epilepsy and multiple sclerosis (MS). Children living with the severe forms of epilepsy, Lennox Gastaut syndrome and Dravet syndrome can now receive Epidyolex® while individuals living with MS can now receive Sativex® for the relief of spasticity.
Clinical trials involving the cannabidiol (CBD)-containing oral solution Epidyolex have demonstrated that some children taking it can experience 40% reduction in epileptic seizures.
While approved for use in Europe in September 2019, guidance from NICE initially advised that Epidyolex was not a cost-effective treatment for epileptic seizures. However, the manufacturer GW Pharmaceuticals (London, UK) have since agreed to supply the medication to the NHS at a discounted price.
“Many families come to us asking about the potential of cannabis-based medicines, particularly CBD, and we are thrilled that one is now available on the NHS,” commented Galia Wilson (Dravet Syndrome UK, Chesterfield, UK).
However, there have been questions posed relating to the long-term effects of taking Epidyolex. “The need for new treatment options is unquestionable and it is reassuring that the new medication has been through clinical trials and regulatory processes. But the time frame for these means we still cannot be certain of the long-term efficacy of this CBD product or what its effect might be on the developing brain,” explained Ley Sander (Epilepsy Society, Chalfont St Peter, UK).
The other medication, Sativex, a mouth spray containing both CBD and delta-9 tetrahydrocannabinol, has been available from the NHS in Wales for the treatment of spasticity associated with MS since 2014. However, concerns over cost-effectiveness meant that it was not available from NHS England.
This decision has now been reversed and Sativex will now be available to patients in England and Northern Ireland for the treatment of spasticity only. Doctors will be unable to prescribe the medication for the treatment of pain.
“These guidelines are an important first step, but don’t go far enough. No cannabis-based treatments have been recommended to treat pain, a common symptom of MS,” concluded Genevieve Edwards (Multiple Sclerosis Society UK, London, UK).
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