A trial has started at UCLH of a treatment that mimics the properties of cannabis to help reduce spasticity associated with multiple sclerosis (MS).
One of the most common and disabling symptoms of MS, spasticity affects up to 80 per cent of patients, causing muscle stiffness, spasms and reduced mobility.
Many people with MS use cannabis medically to alleviate symptoms, but often suffer unwanted side effects like lethargy. Current treatments derived from cannabis are only moderately effective in reducing symptoms and also leave patients feeling fatigued and sedated.
The new drug, discovered at UCL, is called VSN16R and does not produce the sedative effect of current drugs. It was developed with the aim of finding a synthetic compound that interacts with the body’s own cannabinoid receptors without the disadvantages of other drugs.
Our bodies produce what are known as cannabinoid receptors (proteins) in the brain which controls part of the brain involved in pain sensation, mood and memory. These receptors activate those parts of the brain when triggered by naturally-occurring chemicals known as endocannabinoids. Chemicals found in cannabis mimic the effect of endocannabinoids. VSN16R works on a neural pathway which controls excessive nervous excitability and so reduces the symptoms that result from damage caused by MS. The trial is being led by BRC-supported Dr Rachel Farrell, a consultant at the National Hospital for Neurology and Neurosurgery.
Dinah Greek, 58, from Plymouth, took part in the trial earlier this year. She was 34 when she was diagnosed with secondary progressive MS.
“It was fairly benign for about 11 years, but in 2004 it started to ramp up,” said Dinah.
“Day-to-day the disease affects my right leg the most, where I experience terrible spasticity. I had been a reporter going out to Bosnia and Kosovo, and that just wasn’t possible with the way MS affected me. It puts a dampener on many things. I love to walk, I use to get out and climb Helvellyn and go to the gym.”
Other drugs which Dinah has tried have brought other problems with them – like not feeling alert, a severely limiting side-effect for a journalist advising consumers on law.
“This trial is incredibly exciting,” said Dinah. “A cure for MS is the Holy Grail but this is a close second. A drug that lets you work when you want to, and play when you want to, would be fantastic.”
Dr Farrell said: “Participants are only dosed for a four week period which is enough to show whether VSN16R impacts on spasticity. We hope to have the trial fully recruited within six to nine months and completed within a year.”
Professor Bryan Williams, BRC Director, said: “At the BRC we pride ourselves on being leaders in translating biomedical research into clinical research that benefits patients. The trial is a tremendous step forward and has the potential to help ease the suffering of some of those who have to live with the reality of MS every day.”
This project has been collaboration between UCL drug design scientists and the neuroscience team at Queen Mary. This link between basic and clinical science in London has enabled the phase II trials of this new medicine – first beginning at UCLH and with Barts Health NHS Trust to join soon.