title: Fampridine treatment and walking distance in multiple sclerosis: A randomised controlled trial.
abstract: OBJECTIVE
  To explore the benefits of modified-release fampridine on walking distance in MS.
  
  
  METHODS
  This was a randomised double-blind, placebo-controlled crossover trial of fampridine in 25 MS patients. The primary outcome measure was the six minute walk test (6MWT). A p-value<10% led to rejection of the null hypothesis.
  
  
  RESULTS
  The pre-specified criterion for statistical significance was met, with a 17m improvement in 6MWT in the treatment arm. In addition, baseline S2 accommodation, a nerve excitability parameter that reflects slow K+channel activity, modified the effect of fampridine. For patients who had abnormally high S2 accommodation values, there was a 28m improvement in the 6MWT (p=0.04). In contrast, for patients with low S2 values, a 0m improvement was noted (p=1.0).
  
  
  CONCLUSIONS
  The study provides evidence that fampridine may improve walking distance. Nerve excitability assessment may be useful in selecting those patients who are most likely to gain benefit from fampridine.
  
  
  CONCLUSIONS
  Fampridine may improve walking distance in MS. Nerve excitability assessment may assist in identifying those patients most likely to respond to fampridine.
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Pickering
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Jenna
authors.initials: J
authors.lastname: Murray
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors.forename: Cindy S-Y
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Cormack
authors.affiliation: NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Martin
authors.affiliation: Brain and Mind Centre, University of Sydney, Sydney, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Kiernan
authors.affiliation: Prince of Wales Clinical School, University of New South Wales, Sydney, Australia. Electronic address: Arun.Krishnan@unsw.edu.au.
authors.forename: Arun V
authors.initials: AV
authors.lastname: Krishnan
mesh_terms: D015761:4-Aminopyridine / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000188:drug therapy*; D026902:Potassium Channel Blockers / Q000008:administration & dosage*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D026902:Potassium Channel Blockers; D015761:4-Aminopyridine
keywords: Fampridine; Ion channel; Multiple sclerosis; Nerve excitability; Potassium channel