Ampyra Does More Than Improve Walking in MS Patients
People with multiple sclerosis (MS) who have been prescribed Ampyra (extended release dalfampridine) may hope to improve their walking speed. Results of a new small study, however, suggest MS patients may experience more benefits from the drug.
The surprising findings were reported at the Consortium of Multiple Sclerosis Centers and the Americas Committee for Treatment and Research in Multiple Sclerosis (CMSC-ACTRIMS). Albert Lo, MD, PhD, of Mount Sinai Rehabilitation Hospital in Hartford, Connecticut, explained that 39 patients who finished 14 weeks of treatment with standard doses of dalfampridine enjoyed, on average, significant improvement in other physical functions, including
- Walking endurance
- Control of lower extremities
- Subjective feelings about one’s own ability to walk
- Digital (finger) dexterity
- Coarse hand-arm function
Study participants had had MS for a mean of 13 years and about 75 percent of them were women. Tests of walking, lower extremity, and upper extremity function were conducted at baseline and at four visits during the trial.
Individuals who showed improvement in 25-foot walking times three out of four times after baseline were defined as responders, of which there were 20. Some patients experienced no improvement in walking (nonresponders) but did get better function in other areas.
One curious finding was that overall, the patients’ self-assessment of their walking ability improved by about 15 points on the 60-point scale. This information was surprising given that the nonresponders showed little or no objective improvement in walking ability.
Other studies of dalfampridine and MS
In another recent study appearing in Multiple Sclerosis International, 20 patients with MS participated in a 14-week study during which they took 10 mg or prolonged-release dalfampridine twice a day. Eight (40%) of the participants showed improvement in walking speed and balance while standing while 12 (60%) did not.
Research reported in February 2014 in the Journal of the Neurological Sciences commented on the short- and long-term effects of dalfampridine on motor and cognitive function. Thirty of 52 patients continued treatment for 9 to 12 months.
At the first assessment, which was two weeks after starting treatment, significant benefits were seen in the 25-foot walk, maximum walking distance, and in cognitive fatigue. These advantages persisted after 9 to 12 months. However, significant improvement in velocity were only seen after two weeks of treatment.
Results of an Oregon study just appeared in the May 2014 issue of Multiple Sclerosis and noted the impact of dalfampridine on walking speed and endurance as well as community participation in 39 veterans (83% male) with MS. Most of the participants (68%) had progressive MS, while the remaining individuals had relapsing-remitting MS.
All of the patients were prescribed dalfampridine, but only 24 (62%) continued to take it. At the initial follow-up, the patients showed improvements in walking speed, community participation, walking endurance, and self-perceived ability to walk. At one year, the latter two factors still showed significant improvement but not the former two.
MS treatment with dalfampridine has been shown to improve not only the ability to walk but other associated factors such as speed and endurance. New research has now brought to light the potential for dalfampridine to provide other benefits for MS patients.
Cameron MH et al. Dalfampridine improves walking speed, walking endurance, and community participation in veterans with multiple sclerosis: a longitudinal cohort study. Multiple Sclerosis 2014 May; 20(6): 733-38
Consortium of Multiple Sclerosis Centers and the Americas Committee for Treatment and Research in Multiple Sclerosis (CMSC-ACTRIMS)
Prosperini L et al. Oral dalfampridine improves standing balance detected at static posturography in multiple sclerosis. Multiple Sclerosis International 2014; 2014:802307
Ruck T et al. Long-term effects of dalfampridine in patients with multiple sclerosis. Journal of the Neurological Sciences 2014 Feb 15; 337(1-2): 18-24