Abstract
We report a 14-week post-marketing experience on 20 patients with multiple sclerosis (MS) who started prolonged-release (PR) oral dalfampridine 10 mg twice daily according to European Medicine Agency criteria. They underwent serial static posturography assessments and the dizziness handicap inventory (DHI) to investigate whether PR dalfampridine could impact standing balance and self-reported perception of balance. The incidence of accidental falls per person per month was also recorded throughout the study. Eight (40%) patients, who had a relevant improvement in walking speed, were defined as treatment responders. They showed a significant improvement of standing balance (with respect to pretreatment assessment) when contrasted with 12 (60%) nonresponders (F [4,15] = 3.959, P = 0.027). No significant changes in DHI score, as well as in its functional, physical, and emotional subscales, were found in both responders and nonresponders at the end of study (all P values are ≥0.2). Treatment response did not affect the incidence of accidental falls. Future studies based on larger sample sizes, and with longer followup, are required to confirm the beneficial effect of PR dalfampridine on standing balance.
Highlights
Reduced mobility, especially in walking, is probably the impairment most frequently accounted as compromising daily life activities of patients with multiple sclerosis (MS) [1]
We investigated whether PR dalfampridine could impact standing balance, perception of balance, and incidence of accidental falls in a cohort of patients with MS
Administration of PR dalfampridine started for all patients at WK 0 visit, and response to treatment was assessed after a 2-week run-in period, according to previously established criteria based on 25-foot walking test (25-FWT) [7]
Summary
Especially in walking, is probably the impairment most frequently accounted as compromising daily life activities of patients with multiple sclerosis (MS) [1]. Lack of balance/coordination is reported by patients with MS as one of the most common symptoms affecting mobility (67%), together with leg weakness (81%), fatigue (73%), and inability to walk long distances (69%) [2]. Several randomized clinical trials demonstrated that PR dalfampridine can improve walking speed by approximately 25% in more than one-third of treated patients; it can significantly improve perception of ambulatory performance and lower extremity strength [6,7,8,9]. Higher incidence of dizziness and balance disorders has been described as a common adverse event in PR dalfampridine-treated patients [8, 9]. We investigated whether PR dalfampridine could impact standing balance, perception of balance, and incidence of accidental falls in a cohort of patients with MS
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