Historical overview of the rationale for the pharmacological use of prolonged-release fampridine in multiple sclerosis. Issue 6 (November 2012)

• Record Type: Journal Article
• Authors: Fernandez, Oscar; Berger, Thomas; Hartung, Hans-Peter; Putzki, Norman
• Is Part Of: Expert review of clinical pharmacology. Volume 5:Issue 6(2012)
• Page Start: 649
• Page End: 665
• Publication Date: 2012-11
• Subjects: 4-aminopyridine -- dalfampridine -- FAMPYRA® -- immediate-release fampridine -- multiple sclerosis -- prolonged-release fampridine -- walking impairment -- walking speed; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1586/ecp.12.59
• Languages: English
• ISSNs: 1751-2433

Abstract

Multiple sclerosis is a progressive demyelinating neurological disease resulting in long-term disability, commonly manifesting in walking impairment and reduced quality of life. The use of the potassium channel blocker fampridine, chemically 4-aminopyridine, as an immediate-release formulation to improve action potential conduction in demyelinated axons was hampered by adverse events, including seizures. The prolonged-release formulation of fampridine (known as modified- or sustained-release fampridine in some countries and dalfampridine extended release in the USA) has a longer apparent half-life and a lower peak plasma concentration versus immediate-release fampridine formulations, sustaining its duration of action and reducing the incidence of adverse events. Prolonged-release fampridine is the first drug specifically licensed to improve walking in patients with multiple sclerosis, and has been shown to consistently improve walking ability in a third of patients. Prolonged-release fampridine Timed-Walk Responders showed both clinically significant improvements in walking speed and in patient-reported walking ability.