A. Blight, Herbert R. Henney, Ron Cohen
Nov 1, 2014
Citations
0
Influential Citations
21
Citations
Journal
Annals of the New York Academy of Sciences
Abstract
Walking impairment is a clinical hallmark of multiple sclerosis (MS). Dalfampridine‐ER, an extended‐release formulation of dalfampridine (also known by its chemical name, 4‐aminopyridine, and its international nonproprietary name, fampridine), was developed to maintain drug plasma levels within a narrow therapeutic window, and assessed for its ability to improve walking in MS. The putative mechanism of action of dalfampridine‐ER is restoration of axonal conduction via blockade of the potassium channels that become exposed during axonal demyelination. Two pivotal phase III clinical trials demonstrated that dalfampridine‐ER 10‐mg tablets administered twice daily improved walking speed and patient‐reported perceptions of walking in some patients. Dalfampridine‐ER was generally well tolerated, and, at the approved dose, risk of seizure was neither elevated relative to placebo nor higher than the rate in the MS population. Dalfampridine‐ER (AMPYRA®) was approved in the United States for the treatment of walking in patients with MS as demonstrated by an increase in walking speed. The use of the dalfampridine‐ER is contraindicated in patients with a history of seizure. It is the first pharmacologic therapy for this indication and has been incorporated into clinical management of MS.