title: Sustained-release fampridine (4-aminopyridine) in multiple sclerosis: efficacy and impact on motor function.
abstract: OBJECTIVE
  The aim of this study was to determine the efficacy of sustained-release fampridine (4-aminopyridine) in veterans with multiple sclerosis (MS) with limited ambulatory ability, and its impact on motor function in an outpatient setting.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Tertiary referral center [Veterans Affairs (VA) Medical Center].
  
  
  METHODS
  Veterans; 20 MS patients were prescribed dalfampridine (10 mg twice daily) due to their difficulty with walking based on patient and caregiver report and clinician impression of change in the ability to ambulate based on prior 10-meter (10M) and 2-minute walk tests (2MWTs).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The primary outcome measures were mean changes in walking speed (10M walk test), walking distance (2MWT), and Total Functional Independence Measure (TFIM). Improvement of >20% in walking speed was indicated as a clinically meaningful change.
  
  
  RESULTS
  Treatment with dalfampridine resulted in significant improvement in walking speed and endurance (p < 0.05). Walking speed increased by 33% and walking endurance by 31%, representing clinically meaningful improvement. This change was not influenced by change in muscle tone. This improvement in mobility was associated with a clinically significant change in motor function. Adverse effects, including insomnia, dizziness, and headache, were experienced by five patients who discontinued the medication after a minimum of 4 weeks.
  
  
  CONCLUSIONS
  Treatment with dalfampridine resulted in clinically relevant improvements in walking speed and endurance in MS patients with limited ambulation and helped improve their motor function.
authors.affiliation: Department of Neurology, Oklahoma University and Oklahoma City VA Medical Center, 921 NE 13th Street, Oklahoma City, OK, 73034, USA, rabadimh@gmail.com.
authors.forename: Meheroz H
authors.initials: MH
authors.lastname: Rabadi
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kreymborg
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Vincent
mesh_terms: D015761:4-Aminopyridine / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D005080:Exercise Test; D005684:Gait / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology; D026902:Potassium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016138:Walking
chemical_list: D003692:Delayed-Action Preparations; D026902:Potassium Channel Blockers; D015761:4-Aminopyridine