Preliminary Evaluation of Fampridine in Multiple Sclerosis: Beyond the Gait Speed
DOI:
https://doi.org/10.25759/spmfr.265Keywords:
Fampridine, Gait, Multiple Sclerosis, Postural BalanceAbstract
Introduction: The purpose of this study is to assess the impact of fampridine on walking, balance and perception of walking capacity in multiple sclerosis patients.
Material and Methods: Prospective, open-label, non-controlled and non-randomized study on multiple sclerosis patients with an Expanded Disability Status scale (EDSS) between 4 and 7, treated with fampridine. For the evaluation of the impact of fampridine were used: Multiple Sclerosis Walking scale 12 (MSWS-12), Timed 25-Foot Walk (T25FW), Timed Up and Go (TUG) and Berg scale. The results were statistically analysed with statistical significance set to p < 0.05.
Results: A total of 15 patients (88.24%) were considered responders. The improvement in balance, gait velocity and perception on walking capacity were statistically significant with mean value of 19.08% (± 31.11) on T25FW (p = 0.022), 19.20% (± 26.13) on BBS (p = 0.012), 35.97% (± 34.93) on TUG (p = 0.022) and 12.99% (± 12.90) on MSWS-12 (p = 0.016). This study showed a strong and statistically significant correlation between TUG and T25FW (r = 0.668, p = 0.017).
Conclusion: The preliminary results show fampridine potential for gait, balance improving and improvement on perception of walking capacity. Further research is needed to identify and characterize predictors of responsiveness and evaluate other potential functional outcomes.
Downloads
References
Cocks AJ, Young WR, Burschka JM, Hansen S, Hofstadt-van Oy U, et al. Dynamic walking features and improved walking performance in multiple sclerosis patients treated with fampridine (4-aminopyridine). BMC Neurol. 2015;15:17.
Blight AR, Henney HR, Cohen R. Development of dalfampridine, a novel pharmacologic approach for treating walking impairment in multiple sclerosis. Ann N Y Acad Sci. 2014; 1329:33-44.
Dutta R, Trapp BD. Pathogenesis of axonal and neuronal damage in multiple sclerosis. Neurology. 2007;68: S22–S31.
Rudick RA, Cutter G, Reingold S. The Multiple Sclerosis Functional Composite; a new clinical outcome measure for multiple sclerosis clinical trials. Mult Scler. 2002; 8: 359–65.
Dunn J. Impact of mobility impairment on the burden of caregiving in individuals with multiple sclerosis. Expert Rev Pharmacoecon Outcomes Res. 2010; 10: 433–40.
Pike J, Jones E, Rajagopalan K, Piercy J, Anderson P. Social and economic burden of walking and mobility problems in multiple sclerosis. BMC Neurol. 2012; 12:94.
Preiningerova JL, Baumhackl U, Csepany T, Czaplinski A, Deisenhammer F, Derfuss T, et al. Recommendations for the use of prolonged-release fampridine in patients with multiple sclerosis (MS). CNS Neurosci Ther. 2013; 19: 302–6.
Dunn J, Blight A. Dalfampridine: a brief review of its mechanism of action and efficacy as a treatment to improve walking in patients with multiple sclerosis. Curr Med Res Opin. 2011; 27: 1415–23.
Krishnan AV, Kiernan MC. Sustained-release fampridine and the role of ion channel dysfunction in multiple sclerosis. Mult Scler. 2013; 19: 385–91.
Jensen HB, Ravnborg M, Dalgas U, Stenager E. 4-Aminopyridine for symptomatic treatment of multiple sclerosis: a systematic review. Ther Adv Neurol Disord. 2014; 7: 97–113.
Chwieduk CM, Keating GM. Dalfampridine extended release: in multiple sclerosis, CNS Drugs. 2010; 24: 883–91.
Goodman AD, Brown TR, Edwards KR, Krupp LB, Schapiro RT, Cohen R, et al. A phase 3 trial of extended release oral dalfampridine in multiple sclerosis. Ann Neurol. 2010 ; 68: 494-502.
Goodman AD, Brown TR, Krupp TR, Schapiro RT, Schwid SR, Cohen, et al. Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. Lancet. 2009; 373: 732-8.
Allart E, Benoit A, Blanchard-Dauphin A, Tiffreau V, Thevenon A, Zephir H, et al. Sustained-released fampridine in multiple sclerosis: effects on gait parameters, arm function, fatigue, and quality of life. J Neurol. 2015; 262: 1936-45.
Pavsic K, Pelicon K, Ledinek AH, Sega S. Short-term impact of fampridine on motor and cognitive functions, mood and quality of life among multiple sclerosis patients. Clin Neurol Neurosurg. 2015;139:35-40.
Ruck T, Bittner S, Simon OJ, Göbel K, Wiendl H, Schilling M, et al., Longterm effects of dalfampridine in patients with multiple sclerosis. J Neurol Sci. 2014; 337: 18–24.
Goodman AD, Bethoux F, Brown TR, Schapiro RT, Cohen R, Marinucci LN, et al. Long-term safety and efficacy of dalfampridine for walking impairment in patients with multiple sclerosis: results of open-label extensions of two phase 3 clinical trials. Mult Scler. 2015; 21: 1322-31.
Rossini PM, Pasqualetti P, Pozzilli C, Grasso MG, Millefiorini E, Graceffa A, et al., Fatigue in progressive multiple sclerosis: results of a randomized, double-blind, placebo-controlled, crossover trial of oral 4-aminopyridine, Mult Scler. 2001; 7: 354–8.
Jensen HB, Ravnborg M, Mamoei S, Dalgas U, Stenager U. Changes in cognition, arm function and lower body function after slow-release fampridine treatment. Mult Scler. 2014; 20: 1872-8.
Hupperts R, Lycke J, Short C, Gasperini C, McNeill M, Medori R, et al. Prolonged-release fampridine and walking and balance in MS: randomized controlled MOBILE trial. Mult Scler. 2016;22:212-21.
Khan F, Turner-Stokes L, Ng L, Kilpatrick T. Multidisciplinary rehabilitation for adults with multiple sclerosis. Cochrane Database Syst Rev. 2007;2:CD006036.
McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001; 50: 121–7.
Downloads
How to Cite
Issue
Section
License
Copyright statement
Authors must also submit a copyright statement (as seen below) on article submission.
To the Editor-in-chief of the SPMFR Journal:
The below signed author(s) hereby state that the article
________________________________________ (ref. MFR_________) is
an original unpublished work and all facts stated are a product of the author(s) investigation. This article does not violate any copyright laws or privacy statements. The author(s) also hereby confirm that there is no conflict of interest's issues in this article.
By submitting this article the author(s) agree that after publication all copyrights belong to the SPMFR Journal.
Signed by all authors
Date:
Names (capital letters):
Signatures:
The SPMFR Journal’s contents are follow a Creative Commons licence. After publication the authors can hand out the articles as long as the SPMFR Journal is credited.
