Fampridine is a potassium channel blocker. It prolongs channel repolarisation which enhances action potential formation in demyelinated axons, leading to improved neurological function.1
The efficacy of fampridine to improve walking was established in two double-blind studies in which patients with multiple sclerosis were randomised to receive prolonged-release fampridine 10mg twice daily or placebo. Completion of a timed 25-foot walk was used as the primary efficacy endpoint in both studies. Patients who showed a faster walking speed on at least 3 out of 4 occasions, in comparison to their walking speed before treatment, were considered to have responded to treatment.1,2
In one study (n=296), 34.8% of patients taking fampridine responded to the treatment, with an average increase in walking speed of 26.3% vs 5.3% on placebo (p<0.001). The other study (n=237) showed similar results with 42.9% responding to treatment and an increase in walking speed of 25.3% vs 7.8% (p<0.001).1-3
Treatment should be initiated and supervised by a specialist doctor experienced in the management of multiple sclerosis. Treatment should be limited to two weeks by which time any clinical benefits should have been identified. A timed walking test should be used to evaluate improvement after two weeks. If no benefits are observed, Fampyra should be discontinued.1
1. Fampyra Summary of Product Characteristics, 2011.
2. Goodman et al. Lancet 2009; 373: 732–8.
3. Goodman et al. Ann Neurol 2010; 68: 494–502.
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