Contributions
Abstract: P1294
Type: Poster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Background: Modified-release 4-aminopyridine (fampridine-MR) is used as symptomatic treatment of walking disability in patients with multiple sclerosis (MS). Its potential for use in other MS symptoms remains unproven and its mode of action in this context is uncertain.
Hypotheses: (1) Fampridine-MR improves upper limb function in patients with MS and upper limb impairment. (2) Treatment with fampridine-MR is associated with measurable alterations in objective electrophysiological parameters (evoked potentials and transcranial magnetic stimulation (TMS))
Methods: Study population: patients with MS of any disease subtype, duration and severity who have symptomatic impairment of one or both upper limbs. Study design: randomised double blind placebo-controlled trial. Treatment details: participants allocated to either fampridine-MR 10mg bd or placebo of identical appearance for 8 weeks. Primary outcome: performance on 9-hole peg test (9HPT). Secondary outcomes: grip strength; visual acuity and contrast sensitivity; modified fatigue impact scale score; sensory discrimination capacity; visual, somatosensory and motor evoked potentials; resting motor threshold; paired-pulse TMS; peripheral nerve conduction studies. A group of healthy control subjects was included for validation of electrophysiological measures
Results: 40 patients with MS (60% female, median age 52, median disease duration 13.5 years, median EDSS 6.0) and 20 healthy controls (60% female, median age 53) were enrolled. Treatment with fampridine was not associated with any effect on upper limb function as measured by the clinical primary or secondary outcomes. Treatment with fampridine was not associated with any measurable difference in the electrophysiological parameters tested. This held true after adjustment for hand dominance, disease duration and severity. 4 patients withdrew from the trial because of lack of efficacy or side-effects; all were in the placebo arm. Three patients were admitted to hospital during the study period; one with MS exacerbation (placebo), one with syncope (drug) and one with UTI (drug); otherwise there were no serious adverse events.
Conclusion: Treatment with fampridine was well-tolerated but did not produce clinical benefit for upper limb function, vision or fatigue, nor any measurable effect on electrophysiological parameters.
Disclosure: All authors: nothing to disclose
Abstract: P1294
Type: Poster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Background: Modified-release 4-aminopyridine (fampridine-MR) is used as symptomatic treatment of walking disability in patients with multiple sclerosis (MS). Its potential for use in other MS symptoms remains unproven and its mode of action in this context is uncertain.
Hypotheses: (1) Fampridine-MR improves upper limb function in patients with MS and upper limb impairment. (2) Treatment with fampridine-MR is associated with measurable alterations in objective electrophysiological parameters (evoked potentials and transcranial magnetic stimulation (TMS))
Methods: Study population: patients with MS of any disease subtype, duration and severity who have symptomatic impairment of one or both upper limbs. Study design: randomised double blind placebo-controlled trial. Treatment details: participants allocated to either fampridine-MR 10mg bd or placebo of identical appearance for 8 weeks. Primary outcome: performance on 9-hole peg test (9HPT). Secondary outcomes: grip strength; visual acuity and contrast sensitivity; modified fatigue impact scale score; sensory discrimination capacity; visual, somatosensory and motor evoked potentials; resting motor threshold; paired-pulse TMS; peripheral nerve conduction studies. A group of healthy control subjects was included for validation of electrophysiological measures
Results: 40 patients with MS (60% female, median age 52, median disease duration 13.5 years, median EDSS 6.0) and 20 healthy controls (60% female, median age 53) were enrolled. Treatment with fampridine was not associated with any effect on upper limb function as measured by the clinical primary or secondary outcomes. Treatment with fampridine was not associated with any measurable difference in the electrophysiological parameters tested. This held true after adjustment for hand dominance, disease duration and severity. 4 patients withdrew from the trial because of lack of efficacy or side-effects; all were in the placebo arm. Three patients were admitted to hospital during the study period; one with MS exacerbation (placebo), one with syncope (drug) and one with UTI (drug); otherwise there were no serious adverse events.
Conclusion: Treatment with fampridine was well-tolerated but did not produce clinical benefit for upper limb function, vision or fatigue, nor any measurable effect on electrophysiological parameters.
Disclosure: All authors: nothing to disclose