The effect of Fampridine (4-aminopyridine) in physical activity during weekdays and weekends in persons with multiple sclerosis

Abstract

Fampridine (4-aminopyridine) improves walking in persons with multiple sclerosis (PwMS) in a standardized context. However, little is known about its impact on PwMS's physical activity in a real context. Indeed, the International Classification of Functioning Disability and Health defines the performance as a reflection of what an individual does in his/her life, providing crucial information on how she/he interacts with his/her environment. The aim of our study was to determine if Fampridine has an impact on physical activity of PwMS in their real-life environment during weekdays and weekends. In this monocentric open label trial, 42 PwMS (mean [SD] age: 51.2 [12.6] y) and 16 healthy persons (47.9 [7.6] y) were included. The level of physical activity in real-life condition was measured with accelerometers during weekdays and weekends before and after 14 days of Fampridine treatment prescribed according to guidelines of the French Health Products Safety Agency (10 mg twice daily). For PwMS after Fampridine treatment, the only significant difference was the average number of counts on the Sunday ( P = 0.03, d = 0.3). For the comparisons among weekdays, Saturday and Sunday, no significant difference was found for all parameters studied. For the comparisons between groups, PwMS had a number of counts that was significantly smaller than the control group even after Fampridine treatment ( P = [0.04–10 −4 ]). However, after Fampridine treatment, the effect sizes decreased for all parameters, especially for the Sunday (before d = 1.2, after d = 0.7 SD). Fampridine improved the level of activity on the Sunday in PwMS. Fampridine did not change the level of activity between weekdays and weekends for the PwMS group, although there was a decrease in the difference between PwMS and controls on the Sunday. These evidences confirms previous results suggesting modest benefits of Fampridine in the daily physical activity behavior of PwMS. Our results suggest that, despite Fampridine decreasing the difference between PwMS and healthy peers, other therapeutic strategies would be necessary to increase patients’ level of activity in daily life.