Real-life experience with fampridine (Fampyra^®) for patients with multiple sclerosis and gait disorders

Article type: Research Article

Authors: Fragoso, Yara Dadalti^{a; *} | Adoni, Tarso^b | Alves-Leon, Soniza Vieira^c | Apostolos-Pereira, Samira Luisa^d | Barreira, Amilton Antunes^e | Brooks, Joseph Bruno Bidin^a | Claudino, Rinaldo^f | Correa, Eber Castro^g | Ferreira, Maria Lucia Brito^h | Finkelsztejn, Alessandroⁱ | Finkelsztejn, Julianaⁱ | da Gama, Paulo Diniz^j | Goncalves, Marcus Vinicius Magno^k | Guerreiro, Carlos Tostes^e | da Cunha Matta, Andre Palma^l | Marques, Vanessa Daccach^e | Rizo Morales, Rogerio^m | Parolin, Monica Fiuza Konckeⁿ | de Castro Ribeiro, Marlise^o | Ribeiro, Taysa Alexandrino Gonsalves Jube^p | Ruocco, Heloisa Helena^q | Sato, Henry^r | Scherpenhuijzen, Simone^c | Siquineli, Fabio^s | de Carvalho Sousa, Nise Alessandra^t | Varela, Daniel Lima^u | Tauil, Carlos Bernardo^v | Winckler, Thereza Cristina^w

Affiliations: [a] Department of Neurology, Universidade Metropolitana de Santos, Santos, SP, Brazil | [b] Department of Neurology, Hospital Sirio Libanes, Sao Paulo, SP, Brazil | [c] Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil | [d] Department of Neurology, Universidade de Sao Paulo, Sao Paulo, SP, Brazil | [e] Department of Neurology, Universidade de Sao Paulo campus Ribeirao Preto, Ribeirao Preto, SP, Brazil | [f] Department of Neurology, Universidade Federal de Santa Catarina, Florianopolis, SC, Brazil | [g] Department of Neurology, CLINEN, Brasilia, DF, Brazil | [h] Department of Neurology, Hospital da Restauracao, Recife, PE, Brazil | [i] Department of Neurology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil | [j] Department of Neurology, Pontificia Universidade Catolica Campus Sorocaba, Sorocaba, SP, Brazil | [k] Department of Neurology, Centro Hospitalar Unimed, Joinville, SC, Brazil | [l] Department of Neurology, Universidade Federal Fluminense, Niteroi, RJ, Brazil | [m] Department of Neurology, Universidade Federal de Uberlandia, Uberlandia, MG, Brazil | [n] Department of Neurology, Neurology Clinic, Curitiba, PR, Brazil | [o] Department of Neurology, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS, Brazil | [p] Department of Neurology, Universidade Federal de Goias, Goiania, Brazil | [q] Department of Neurology, Faculdade de Medicina de Jundiai, Jundiai, SP, Brazil | [r] Department of Neurology, Neurological Institute Curitiba, Curitiba, PR, Brazil | [s] Department of Neurology, Universidade Regional de Blumenau, Blumenau, SC, Brazil | [t] Department of Neurology, Hospital Universitario Getulio Vargas, Manaus, AM, Brazil | [u] Department of Neurology, Servico de Neurologia e Neurocirurgia de Passo Fundo, Passo Fundo, RS, Brazil | [v] Department of Neurology, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil | [w] Department of Neurology, Universidade Positivo, Curitiba, PR, Brazil

Correspondence: [*] Address for correspondence: Y.D. Fragoso, Department of Neurology, Medical School, UNIMES, Rua da Constituicao 374, CEP 11015-470, Santos SP, Brazil. E-mail: yara@bsnet.com.br.

Abstract: BACKGROUND: Fampridine is a broad-spectrum voltage-dependent potassium channel blocker that enhances synaptic transmission. The drug has been shown to be able to ameliorate conduction in demyelinated axons, thereby leading to improved gait in patients with multiple sclerosis (MS). OBJECTIVE: To assess the “real-life” efficacy and safety of fampridine prescribed for gait disorders in MS. This was an observational and prospective study carried out at MS Units participating in the Brazilian Multiple Sclerosis Study Group. METHODS: Patients with MS and gait disorders were prescribed fampridine (10 mg twice a day), irrespectively of the degree of disability determined by MS. Neurological disability determined by MS was assessed with the expanded disability scale score (EDSS). Outcomes for efficacy and safety of the drug were evaluated by the 25 foot-walk test and by the adverse events of fampridine. RESULTS: The time taken to walk 25 feet decreased by 20% or more in 62 patients (70%). Twenty-five patients were considered to be non-responders to this treatment. Improvement in walking speed was independent of improvement of disability. Mild or moderate adverse events were reported in 8% of patients. CONCLUSION: Fampridine is an efficient and safe therapeutic option for patients with MS and gait disorders.

Keywords: Multiple sclerosis, gait, walking, fampridine

DOI: 10.3233/NRE-161361

Journal: NeuroRehabilitation, vol. 39, no. 2, pp. 301-304, 2016