Long-term effects of dalfampridine in patients with multiple sclerosis

J Neurol Sci. 2014 Feb 15;337(1-2):18-24. doi: 10.1016/j.jns.2013.11.011. Epub 2013 Nov 16.

Abstract

Background/objective: Dalfampridine is the extended-release formulation of 4-aminopyridine and is approved for the symptomatic treatment of impaired mobility in patients with multiple sclerosis. Our aim was to examine the short- and long-term effects of treatment with dalfampridine on motoric and cognitive assessment parameters of multiple sclerosis (MS) patients over 9-12 months.

Methods: Fifty-two patients with MS with an EDSS between 4.0 and 7.0 and impaired mobility were evaluated for parameters of walking ability, MSFC, cognitive and motor fatigue and evoked potentials at treatment initiation with dalfampridine as well as 2 weeks and after 9-12 months later.

Results: Thirty out of fifty-two patients (~60%) were still on treatment after 9-12 months. Two weeks after treatment initiation, significant ameliorations could be found for T25FW, maximum walking distance as well as motoric and cognitive fatigue which still persisted after 9-12 months. In contrast significant effects for velocity were observed only after 2 weeks, for improvement in PASAT only after 9-12 months. A tendency for improvement of somatosensory evoked potentials was found in a subset of patients.

Conclusion: Dalfampridine shows positive short- and long-term effects on motoric and cognitive assessment parameters in an open-label observational study in a cohort of patients with MS.

Keywords: Dalfampridine; Fatigue; Long-term treatment; MS; Mobility; Walking ability.

MeSH terms

  • 4-Aminopyridine / therapeutic use*
  • Cognition Disorders / drug therapy
  • Cognition Disorders / etiology
  • Disability Evaluation
  • Drug Delivery Systems
  • Electroencephalography
  • Evoked Potentials / drug effects
  • Evoked Potentials / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / drug therapy*
  • Potassium Channel Blockers / therapeutic use*
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors
  • Walking / physiology

Substances

  • Potassium Channel Blockers
  • 4-Aminopyridine