Therapeutic Advances in Neurological Disorders (Jun 2018)

Combined walking outcome measures identify clinically meaningful response to prolonged-release fampridine

  • Núria Sola-Valls,
  • Yolanda Blanco,
  • María Sepúlveda,
  • Sara Llufriu,
  • Elena H. Martínez-Lapiscina,
  • Irati Zubizarreta,
  • Irene Pulido-Valdeolivas,
  • Carmen Montejo,
  • Pablo Villoslada,
  • Albert Saiz

DOI
https://doi.org/10.1177/1756286418780007
Journal volume & issue
Vol. 11

Abstract

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Background: Gait impairment is common in multiple sclerosis (MS) and negatively impacts patients’ health-related quality of life (HRQoL). Prolonged-release fampridine (PR-fam) improves walking speed, but it is unclear which walking measures are the most suitable for identifying treatment response. Our aim was to assess the effect of PR-fam and the outcome measures that best identify short- and long-term clinically meaningful response. Methods: We conducted a prospective study in 32 MS patients treated with PR-fam for a year. The assessments at 2 weeks, 3, 6 and 12 months included: timed 25-foot walk (T25FW), 6-minute walk test (6MWT), MS Walking Scale-12 (MSWS-12), a five-level version of the EuroQoL-5 dimensions, and accelerometry. PR-fam response was defined as an improvement in T25FW ⩾20%. Results: Twenty-five (78%) patients were considered responders after 2 weeks of PR-fam and improved significantly in all measures. Responders to T25FW and MSWS-12 ( n = 19) showed a significant improvement in HRQoL and accelerometer data compared with responders only to T25FW ( n = 6). At 1 year, 15/20 (75%) patients remained responders, but only those with permanent response to T25FW and MSWS-12 ( n = 8; 53%) showed a significant improvement in 6MWT and HRQoL. Conclusion: The combination of T25FW and MSWS-12 identify better those patients with a clinically significant benefit of PR-fam.