Abstract：
BACKGROUND: Cannabinoids are approved for spasticity and pain in multiple sclerosis (MS). In 2017 the prevalence of current users in the Italian general population was 10.2%, while data on Italian MS patients are limited.
METHODS: From March 2022 to February 2023, we conducted a multicenter, cross-sectional study. Adult MS patients completed an anonymous online survey. The primary outcome was the estimated prevalence of unprescribed cannabis current use. Cannabis use patterns and associations with clinical and socio-demographical variables were investigated. The binomial method was used to estimate 95% confidence interval (95% CI) for primary outcome.
RESULTS: 5620 patients were invited and 2024 (36.0%) were included (mean age 45.2 years, females 64.5%). Relapsing remitting form was the most frequent (77.3%). Median expanded disability status scale (EDSS) was 2.0. The proportion of current users was 15.5% (95% CI 13.9-17.1) and 36.4% of them disclosed to their physician their unprescribed cannabis use. 15.0% patients were former users while 69.5% never used cannabis. Current users more frequently reported a medical use (i.e., current medical users) compared to former users (p < 0.001). 41.1% of never users would use cannabis if it was legal. Young age, being male, and a free marital status were associated with current use. Current medical users had higher disability, spasticity and pain, reduced quality of life, concomitant neurological/psychiatric drugs and analgesics use. Unprescribed cannabis appeared relatively safe, with limited addiction risk, and reported clinical benefits, including concomitant medications reduction.
CONCLUSIONS: Unprescribed cannabis use is common in patients with MS in Italy, with observed prevalence seemingly superior to the general population, often intended for medical use and without the disclosure to the treating physician, although with potential clinical benefits.
METHODS: From March 2022 to February 2023, we conducted a multicenter, cross-sectional study. Adult MS patients completed an anonymous online survey. The primary outcome was the estimated prevalence of unprescribed cannabis current use. Cannabis use patterns and associations with clinical and socio-demographical variables were investigated. The binomial method was used to estimate 95% confidence interval (95% CI) for primary outcome.
RESULTS: 5620 patients were invited and 2024 (36.0%) were included (mean age 45.2 years, females 64.5%). Relapsing remitting form was the most frequent (77.3%). Median expanded disability status scale (EDSS) was 2.0. The proportion of current users was 15.5% (95% CI 13.9-17.1) and 36.4% of them disclosed to their physician their unprescribed cannabis use. 15.0% patients were former users while 69.5% never used cannabis. Current users more frequently reported a medical use (i.e., current medical users) compared to former users (p < 0.001). 41.1% of never users would use cannabis if it was legal. Young age, being male, and a free marital status were associated with current use. Current medical users had higher disability, spasticity and pain, reduced quality of life, concomitant neurological/psychiatric drugs and analgesics use. Unprescribed cannabis appeared relatively safe, with limited addiction risk, and reported clinical benefits, including concomitant medications reduction.
CONCLUSIONS: Unprescribed cannabis use is common in patients with MS in Italy, with observed prevalence seemingly superior to the general population, often intended for medical use and without the disclosure to the treating physician, although with potential clinical benefits.
摘要：
背景：大麻素被批准用于多发性硬化症（MS）的痉挛和疼痛。2017年，意大利普通人群中当前用户的患病率为10.2％，而意大利MS患者的数据有限。
方法：从2022年3月到2023年2月，我们进行了多中心，横断面研究。成年MS患者完成了一项匿名在线调查。主要结果是目前使用非处方大麻的估计流行率。研究了大麻的使用模式以及与临床和社会人口统计学变量的关联。二项法用于估计主要结局的95%置信区间(95%CI)。
结果：邀请了5620名患者，其中包括2024名（36.0％）（平均年龄45.2岁，女性64.5%）。复发缓解形式最常见(77.3%)。扩展残疾状况量表(EDSS)中位数为2.0。当前用户的比例为15.5％（95％CI13.9-17.1），其中36.4％向医生披露了未使用的大麻。15.0％的患者是以前的使用者，而69.5％的患者从未使用过大麻。当前用户更频繁地报告了医疗用途(即，当前医疗用户)与以前的用户相比(p<0.001)。如果合法的话，41.1％的用户永远不会使用大麻。年轻的年龄,作为男性，免费的婚姻状况与当前的使用有关。目前的医疗使用者有更高的残疾，痉挛和疼痛，生活质量下降，伴随神经/精神药物和镇痛药的使用。非处方大麻似乎相对安全，上瘾的风险有限，并报告了临床益处，包括伴随的药物减少。
结论：在意大利MS患者中，非处方大麻使用很常见，观察到的患病率似乎优于一般人群，通常用于医疗用途，并且没有向治疗医生披露，尽管具有潜在的临床益处。
方法：从2022年3月到2023年2月，我们进行了多中心，横断面研究。成年MS患者完成了一项匿名在线调查。主要结果是目前使用非处方大麻的估计流行率。研究了大麻的使用模式以及与临床和社会人口统计学变量的关联。二项法用于估计主要结局的95%置信区间(95%CI)。
结果：邀请了5620名患者，其中包括2024名（36.0％）（平均年龄45.2岁，女性64.5%）。复发缓解形式最常见(77.3%)。扩展残疾状况量表(EDSS)中位数为2.0。当前用户的比例为15.5％（95％CI13.9-17.1），其中36.4％向医生披露了未使用的大麻。15.0％的患者是以前的使用者，而69.5％的患者从未使用过大麻。当前用户更频繁地报告了医疗用途(即，当前医疗用户)与以前的用户相比(p<0.001)。如果合法的话，41.1％的用户永远不会使用大麻。年轻的年龄,作为男性，免费的婚姻状况与当前的使用有关。目前的医疗使用者有更高的残疾，痉挛和疼痛，生活质量下降，伴随神经/精神药物和镇痛药的使用。非处方大麻似乎相对安全，上瘾的风险有限，并报告了临床益处，包括伴随的药物减少。
结论：在意大利MS患者中，非处方大麻使用很常见，观察到的患病率似乎优于一般人群，通常用于医疗用途，并且没有向治疗医生披露，尽管具有潜在的临床益处。
