title: A guide to treating gait impairment with prolonged-release fampridine (Fampyra®) in patients with multiple sclerosis.
abstract: BACKGROUND
  Gait impairment, a frequent sign in multiple sclerosis (MS), places a major burden on patients since it results in progressive loss of personal and social autonomy, along with work productivity. This guide aims to provide recommendations on how to evaluate gait impairment and use prolonged-release fampridine (PR-fampridine) as treatment for MS patients with gait impairment in Spain.
  
  
  METHODS
  PR-fampridine dosed at 10mg every 12hours is currently the only drug approved to treat gait impairment in adults with MS. Additionally, PR-fampridine has been shown in clinical practice to significantly improve quality of life (QoL) in patients who respond to treatment. Treatment response can be assessed with the Timed 25-Foot Walk (T25FW) or the 12-item MS Walking Scale (MSWS-12); tests should be completed before and after starting treatment. The minimum time recommended for evaluating treatment response is 2 weeks after treatment onset. Patients are considered responders and permitted to continue the treatment when they demonstrate a decrease in their T25FW time or an increase in MSWS-12 scores. A re-evaluation is recommended at least every 6 months. The SF-36 (Short Form-36) and the MSIS-29 (MS Impact Scale-29) tests are recommended for clinicians interested in performing a detailed QoL assessment. This drug is generally well-tolerated and has a good safety profile. It should be taken on an empty stomach and renal function must be monitored regularly.
  
  
  CONCLUSIONS
  These recommendations will help ensure safer and more efficient prescription practices and easier management of PR-fampridine as treatment for gait impairment in Spanish adults with MS.
authors.affiliation: Unitat de Neuroimmunologia i Esclerosi Múltiple, Servicio de Neurología, Hospital Universitari Dr. Josep Trueta, Institut d'Investigació Biomèdica de Girona IDIBGI, Girona, España. Electronic address: llramio@idibgi.org.
authors.forename: L
authors.initials: L
authors.lastname: Ramió-Torrentà
authors.affiliation: Unidad de Esclerosis Múltiple, Servicio de Neurología e Inmunología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Álvarez-Cermeño
authors.affiliation: Unidad de Esclerosis Múltiple, Servicio de Neurología, Hospital Clínico San Carlos, Servicio de Neurología, Hospital Quirón, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Arroyo
authors.affiliation: Unidad de Esclerosis Múltiple, Hospital Universitario La Fe, Valencia, España.
authors.forename: B
authors.initials: B
authors.lastname: Casanova-Estruch
authors.affiliation: Servicio de Neurología. Hospital Universitario Carlos Haya, Hospital Universitario Virgen de la Victoria, Málaga, España.
authors.forename: O
authors.initials: O
authors.lastname: Fernández
authors.affiliation: Unidad de Neuroinmunología, Servicio de Neurología, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: J A
authors.initials: JA
authors.lastname: García-Merino
authors.affiliation: Servicio de Neurología, Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Hernández
authors.affiliation: Unidad de Esclerosis Múltiple, Servicio de Neurología, Hospital Virgen de la Macarena, Sevilla, España.
authors.forename: G
authors.initials: G
authors.lastname: Izquierdo
authors.affiliation: Unidad de Esclerosis Múltiple, Hospital de Bellvitge, Barcelona, España.
authors.forename: S
authors.initials: S
authors.lastname: Martínez-Yélamos
authors.affiliation: Unidad de Esclerosis Múltiple, Servicio de Neurología, Hospital Virgen de la Arrixaca, Murcia, España.
authors.forename: J
authors.initials: J
authors.lastname: Meca
authors.affiliation: Servicio de Neurología, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Moral
authors.affiliation: Servicio de Neurología, Unidad de Esclerosis Múltiple, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: J
authors.initials: J
authors.lastname: Olascoaga
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario Santiago de Compostela, CHUS, Santiago de Compostela, A Coruña, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Prieto
authors.affiliation: Servicio de Neurología, Unidad de Esclerosis Múltiple, Hospital Clínic, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Saiz
mesh_terms: D015761:4-Aminopyridine / Q000627:therapeutic use*; D000328:Adult; D020233:Gait Disorders, Neurologic / Q000188:drug therapy*; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications*; D026902:Potassium Channel Blockers / Q000627:therapeutic use*; D011788:Quality of Life; D013030:Spain; D016896:Treatment Outcome
chemical_list: D026902:Potassium Channel Blockers; D015761:4-Aminopyridine
keywords: Calidad de vida; Esclerosis múltiple; Fampridina; Fampridine; Gait impairment; MSWS-12; Marcha; Multiple sclerosis; Quality of life; T25FW; The 12-item multiple sclerosis walking scale; Timed 25-Foot Walk Test