Goal: To judge effectiveness, tolerability and security of an oromucosal spray containing Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), as add-on remedy in sufferers with extreme power ache (SCP). Strategies: Exploratory evaluation of anonymized 12-week routine/open-label knowledge offered by the German Ache e-Registry (GPR) on grownup SCP sufferers handled with THC:CBD oromucosal spray in 2017. Outcomes: Amongst these 30.228 instances documented within the GPR in 2017, 800 (2.6%; 57% feminine, imply ± SD age: 46.3±9.7 years) obtained a remedy with THC:CBD. All sufferers fulfilled the legislative preconditions for a remedy with cannabis as drugs as outlined by the German Act Amending Narcotics and Different Rules. THC:CBD-treatment was adopted by an aggregated nine-factor symptom reduction (ASR-9) enchancment at finish of week 12 vs baseline of 39.0±26.5% (95%-CI: 36.9-41.1, median: 42, vary -41 to 85). A full ASR-9 response (ie, a 50%-improvement in all 9 elements) was discovered for 123 sufferers (15.4%), whereas 488 sufferers (56.0%) offered with an ≥50% enchancment in a minimum of 5 of 9 ASR elements. With a 54.9±17.2% (median: 56%, vary: -6 to 85) enchancment was considerably superior within the neuropathic ache subgroup (n=497, 62.1%) vs these with blended (n=249, 31.1%; ASR-9: 18.2±12.0, median: 19, vary: -12 to 42%) or nociceptive ache (n=54, 6.8%; ASR-9: -11.9±10.5, median: -11, vary: -41% to 12%; p<0.001 for every). 159 sufferers (19.9%) reported a minimum of certainly one of 206 TEAEs, most of them of gentle depth (n=81.6%). Most steadily reported TEAEs have been elevated urge for food (n=50, 6.3%) and dysgeusia (n=23, 2.9%). TEAE-related discontinuations have been reported for 32 sufferers (4.0%). 113 (14.1%) sufferers discontinued resulting from insufficient ache reduction, most of them with nociceptive ache (n=40, 74.1%), least with neuropathic ache (n=1, 0.2%; p<0.001). Conclusion:THC:CBD oromucosal spray proved to be an efficient and well-tolerated add-on remedy for sufferers with elsewhere refractory power ache– particularly of neuropathic origin.