The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS)
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Objective: To test whether cannabinoids reduce urge incontinence episodes without affecting voiding in patients with multiple sclerosis. This was part of the multicentre trial of the Cannabinoids in Multiple Sclerosis (CAMS) study. Subjects and methods: The CAMS study randomised 630 patients to receive oral administration of cannabis extract, Δ9-tetrahydrocannabinol (THC) or matched placebo. For this substudy subjects completed incontinence diaries. Results: All three groups showed a significant reduction, p<0.01, in adjusted episode rate (i.e. correcting for baseline imbalance) from baseline to the end of treatment: cannabis extract, 38%; THC, 33%; and placebo, 18%. Both active treatments showed significant effects over placebo (cannabis extract, p=0.005; THC, p=0.039). Conclusion: The findings are suggestive of a clinical effect of cannabis on incontinence episodes in patients with MS. This is in contrast to the negative finding of the CAMS study, where no difference was seen in the primary outcome of spasticity.
KeywordsCannabis Cannabinoid Multiple sclerosis Urge incontinence Neurogenic detrusor overactivity Controlled trial
This study was funded by a grant from the Multiple Sclerosis Society. The Medical Research Council sponsored the main CAMS study. Solvay Healthcare Ltd. and the Institute for Clinical Research, IKF, Berlin, provided medication. We thank all patients who took part in the study. We acknowledge the assistance of the CAMS study team, particularly Jane Vickery for trial coordination and help with drafting the paper, Wendy Ingram for assistance with figure construction, Hilary Sanders for further statistical support as well as Suzi Reilly, Judy Willcocks, Sue Varley, Mark Warner, Lara Teare, Felicity Coates and Rosemary Bishop (urodynamic nurse).
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