Contributions
Abstract: P1307
Type: Poster
Abstract Category: Therapy - symptomatic - Quality of life
Background: Prolonged release (PR) Fampridine improves walking speed and satisfaction with walking in people with MS (PwMS). It was licensed in the US and EU (conditional) in 2011. Longitudinal data on real-world patient experience on PR-Fampridine is invaluable in guiding the management of MS patients with walking impairment.
Objectives: To develop an MDT walking service to manage severe walking impairment in PwMS incorporating PR-Fampridine in routine clinical practice.
Methodology: People with MS and walking impairment were reviewed in a specialist MDT ambulation clinic since June 2013. Subjective and objective outcomes included: Timed 25 Foot Walk (T25FW), Multiple Sclerosis Walking Scale (MSWS-12), health-related quality of life using the EuroQol 5-dimension instrument, 5-level version (EQ-5D-5L), VAS walking and functional goals of treatment. Follow-up data was collected for existing subjects. New patients treated with PR-fampridine were evaluated for this study. Responder status was defined by ≥20% increase T25FW velocity compared to baseline with concomitant MSWS-12 improvement.
Results: 142 subjects were included. Mean age 52.3 years [34-73 years], 93 female subjects and 49 males were trialled. Mean Expanded Disability Status Score (EDSS) 6.5 [6.0-7.0]. After 2 weeks, 72.9% walked ≥20% faster than baseline. Median change in T25FW velocity was 68.0% [21.2 - 453 %] in responders versus -6.0% [-32.0-12.0%] in non-responders (p< 0.0001). Responders continued walking faster than baseline at 22 months (55.0%, p=0.002), 26 months (78%) and 30 months (75.9%). At 2 weeks, MSWS-12 improved more in responders (-19.0) than non-responders (-11.23) (p=0.073), EQ-5D-5L index changed by +0.166 [-0.402 - +0.740, p< 0.0001] in responders and - 0.03 [-0.909 - +0.541] in non-responders (p< 0.0001). Responders continued to have better EQ-5D-5L index scores at 4 months (+0.116), 10 months (+0.163) and 16 months (+0.087). At 10 months, 83.3% had achieved their treatment goals. At the end of the study period, T25FW responders discontinued PR-Fampridine due to treatment failure (n=32), side effects (n=5), patient choice (n=3), impaired eGFR (n=2), relapse (n=2) and inability to adhere to dosing (n=1)
Conclusio: PR-Fampridine improves walking speed, self-reported walking ability, quality of life and functional ability in an open-label longitudinal study of MS patients with severe walking impairment. Use within an MDT service optimises ability.
Disclosure:
Rachel Farrell is supported by the NIHR Biomedical research centre.
Renee Ewe, Hannah Louissant, Helen Bleasdale, Kate Bull, Ben Beare, Jo Allen: Nothing to declare
Abstract: P1307
Type: Poster
Abstract Category: Therapy - symptomatic - Quality of life
Background: Prolonged release (PR) Fampridine improves walking speed and satisfaction with walking in people with MS (PwMS). It was licensed in the US and EU (conditional) in 2011. Longitudinal data on real-world patient experience on PR-Fampridine is invaluable in guiding the management of MS patients with walking impairment.
Objectives: To develop an MDT walking service to manage severe walking impairment in PwMS incorporating PR-Fampridine in routine clinical practice.
Methodology: People with MS and walking impairment were reviewed in a specialist MDT ambulation clinic since June 2013. Subjective and objective outcomes included: Timed 25 Foot Walk (T25FW), Multiple Sclerosis Walking Scale (MSWS-12), health-related quality of life using the EuroQol 5-dimension instrument, 5-level version (EQ-5D-5L), VAS walking and functional goals of treatment. Follow-up data was collected for existing subjects. New patients treated with PR-fampridine were evaluated for this study. Responder status was defined by ≥20% increase T25FW velocity compared to baseline with concomitant MSWS-12 improvement.
Results: 142 subjects were included. Mean age 52.3 years [34-73 years], 93 female subjects and 49 males were trialled. Mean Expanded Disability Status Score (EDSS) 6.5 [6.0-7.0]. After 2 weeks, 72.9% walked ≥20% faster than baseline. Median change in T25FW velocity was 68.0% [21.2 - 453 %] in responders versus -6.0% [-32.0-12.0%] in non-responders (p< 0.0001). Responders continued walking faster than baseline at 22 months (55.0%, p=0.002), 26 months (78%) and 30 months (75.9%). At 2 weeks, MSWS-12 improved more in responders (-19.0) than non-responders (-11.23) (p=0.073), EQ-5D-5L index changed by +0.166 [-0.402 - +0.740, p< 0.0001] in responders and - 0.03 [-0.909 - +0.541] in non-responders (p< 0.0001). Responders continued to have better EQ-5D-5L index scores at 4 months (+0.116), 10 months (+0.163) and 16 months (+0.087). At 10 months, 83.3% had achieved their treatment goals. At the end of the study period, T25FW responders discontinued PR-Fampridine due to treatment failure (n=32), side effects (n=5), patient choice (n=3), impaired eGFR (n=2), relapse (n=2) and inability to adhere to dosing (n=1)
Conclusio: PR-Fampridine improves walking speed, self-reported walking ability, quality of life and functional ability in an open-label longitudinal study of MS patients with severe walking impairment. Use within an MDT service optimises ability.
Disclosure:
Rachel Farrell is supported by the NIHR Biomedical research centre.
Renee Ewe, Hannah Louissant, Helen Bleasdale, Kate Bull, Ben Beare, Jo Allen: Nothing to declare