Palatability and oral cavity tolerability of THC: CBD oromucosal spray and possible improvement measures in multiple sclerosis patients with resistant spasticity: a pilot study

Complaints about Delta(9)-tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex (R); GW Pharma Ltd, Salisbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC: CBD oromucosal spray to mitigate these effects. Materials & methods: Patients with multiple sclerosis spasticity (n = 52) at six sites in Italy who were receiving THC:CBD oromucosal spray and had associated oral mucosal effects were randomized into Group A (chewing gum; n = 15); Group B (cold bottle; n = 20); and Group C (cold bottle + chewing gum; n = 17). Results: Taste perception in patients receiving chewing gum +/- cold bottle intervention (Groups A and C combined) was significantly (p = 0.0001) improved from baseline to week 4 while maintaining spasticity control. Conclusion: Patient comfort, satisfaction and treatment adherence may benefit from these interventions.