title: Prolonged-release fampridine in multiple sclerosis: Improved ambulation effected by changes in walking pattern.
abstract: Prolonged-release fampridine (PR-fampridine, 4-aminopyridine) increases walking speed in the timed 25-foot walk test (T25FW) in some patients (timed-walk responders) with multiple sclerosis (MS).
  
  
  
  To explore the effects of PR-fampridine on different aspects of walking function and to identify associated gait modifications in subjects with MS.
  
  
  
  In this prospective, randomized, placebo-controlled, double-blind, phase II study (FAMPKIN; clinicaltrials.gov, NCT01576354), subjects received a 6-week course of oral placebo or PR-fampridine treatment (10 mg, twice daily) before crossing over. Using 3D-motion-analysis, kinematic and kinetic parameters were assessed during treadmill walking (primary endpoint). Clinical outcome measures included T25FW, 6-minute walk test (6MWT), and balance scales. Physical activity in everyday life was measured with an accelerometer device.
  
  
  
  Data from 55 patients were suitable for analysis. Seventeen subjects were timed-walk responders under PR-fampridine. For the total study population and for responders, a significant increase in walking speed (T25FW) and distance (6MWT) was observed. Gait pattern changes were found at the single-subject level and correlated with improvements in the T25FW and 6MWT. Physical activity was increased in responders.
  
  
  
  PR-fampridine improves walking speed, endurance, and everyday physical activity in a subset of subjects with MS and leads to individual modifications of the gait pattern.
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland bjoern.zoerner@usz.ch.
authors.forename: Björn
authors.initials: B
authors.lastname: Zörner
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Linard
authors.initials: L
authors.lastname: Filli
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Katja
authors.initials: K
authors.lastname: Reuter
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Sandra
authors.initials: S
authors.lastname: Kapitza
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Lilla
authors.initials: L
authors.lastname: Lörincz
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Tabea
authors.initials: T
authors.lastname: Sutter
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Weller
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland/Europe and Canada Regional Medical, Biogen International GmbH, Zug, Switzerland.
authors.forename: Melinda
authors.initials: M
authors.lastname: Farkas
authors.affiliation: Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Easthope
authors.affiliation: NeuroZentrum Bellevue, Zurich, Switzerland.
authors.forename: Adam
authors.initials: A
authors.lastname: Czaplinski
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland/ Department of Neurology, HELIOS-Klinik Hagen-Ambrock, Hagen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Linnebank
mesh_terms: D015761:4-Aminopyridine / Q000627:therapeutic use*; D000328:Adult; D001696:Biomechanical Phenomena; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D026902:Potassium Channel Blockers / Q000627:therapeutic use*; D016896:Treatment Outcome; D000070857:Walk Test; D000072797:Walking Speed
chemical_list: D003692:Delayed-Action Preparations; D026902:Potassium Channel Blockers; D015761:4-Aminopyridine
keywords: Clinical trial; fampridine; multiple sclerosis; outcome measurement; symptomatic treatment