title: Dalfampridine Effects Beyond Walking Speed in Multiple Sclerosis.
abstract: BACKGROUND
  Dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS), as demonstrated by walking speed improvement. This exploratory study evaluated treatment effects of dalfampridine-ER on gait, balance, and walking through treatment withdrawal and reinitiation.
  
  
  METHODS
  Dalfampridine-ER responders, based on Timed 25-Foot Walk (T25FW) assessment before study entry, were included in this open-label, three-period, single-center study. Period 1: on-drug evaluations performed at screening and 1 week after screening. Period 2: dalfampridine-ER withdrawal and off-drug evaluations (days 5 and 11). Period 3: dalfampridine-ER reinitiation/final on-drug evaluation (day 15).
  
  
  METHODS
  NeuroCom composite scores for gait and balance; balance was evaluated if gait changes were significant. Secondary variables: individual NeuroCom scores, walking speed (T25FW) and distance (2-Minute Walk Test [2MWT]), and balance (Berg Balance Scale [BBS]).
  
  
  RESULTS
  All 20 patients completed the study: mean age, 53.1 years; mean MS duration, 11.3 years; mean time taking dalfampridine-ER, 315.3 days. NeuroCom gait composite scores worsened during period 2 relative to period 1 and improved during period 3; the mean ± SD difference in gait composite scores on drug was 4.03 ± 1.51 points (P = .015). Balance composite scores did not change significantly. Improvements were observed for off-drug versus on-drug for T25FW (0.36 ft/sec, P < .001), 2MWT (25.4 ft, P = .006), and BBS (1.7 points, P = .003). Safety profile was consistent with previous studies.
  
  
  CONCLUSIONS
  Significant improvements in gait, walking speed, distance, and balance were demonstrated by dalfampridine-ER reinitiation after a 10-day withdrawal period.
authors.affiliation: Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence, Oklahoma City, OK, USA (CF, GP); and Acorda Therapeutics Inc, Ardsley, NY, USA (GS, MK, HRH, ALR).
authors.forename: Cecilie
authors.initials: C
authors.lastname: Fjeldstad
authors.affiliation: Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence, Oklahoma City, OK, USA (CF, GP); and Acorda Therapeutics Inc, Ardsley, NY, USA (GS, MK, HRH, ALR).
authors.forename: Gustavo
authors.initials: G
authors.lastname: Suárez
authors.affiliation: Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence, Oklahoma City, OK, USA (CF, GP); and Acorda Therapeutics Inc, Ardsley, NY, USA (GS, MK, HRH, ALR).
authors.forename: Michael
authors.initials: M
authors.lastname: Klingler
authors.affiliation: Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence, Oklahoma City, OK, USA (CF, GP); and Acorda Therapeutics Inc, Ardsley, NY, USA (GS, MK, HRH, ALR).
authors.forename: Herbert R
authors.initials: HR
authors.lastname: Henney
authors.affiliation: Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence, Oklahoma City, OK, USA (CF, GP); and Acorda Therapeutics Inc, Ardsley, NY, USA (GS, MK, HRH, ALR).
authors.forename: Adrian L
authors.initials: AL
authors.lastname: Rabinowicz
authors.affiliation: Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence, Oklahoma City, OK, USA (CF, GP); and Acorda Therapeutics Inc, Ardsley, NY, USA (GS, MK, HRH, ALR).
authors.forename: Gabriel
authors.initials: G
authors.lastname: Pardo