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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Pharmacology

Background:

  • Dalfampridine extended release (ER) is known to enhance walking speed in multiple sclerosis (MS) patients.
  • This study explored the effects of dalfampridine-ER on gait, balance, and walking by examining treatment withdrawal and reinitiation phases.

Purpose of the Study:

  • To evaluate the impact of dalfampridine-ER on gait, balance, and walking parameters in MS patients.
  • To assess the reversibility and re-establishment of treatment effects through a withdrawal and reinitiation protocol.

Main Methods:

  • An open-label, three-period study included dalfampridine-ER responders identified by the Timed 25-Foot Walk (T25FW).
  • Evaluations included on-drug periods, a 10-day drug withdrawal period, and a reinitiation period.
  • Gait and balance were assessed using NeuroCom composite scores, with secondary measures including T25FW, 2-Minute Walk Test (2MWT), and Berg Balance Scale (BBS).

Main Results:

  • All 20 participants completed the study, with mean age 53.1 years and MS duration 11.3 years.
  • NeuroCom gait composite scores significantly worsened during withdrawal and improved upon reinitiation (P = .015).
  • Significant improvements were noted on-drug versus off-drug for T25FW (P < .001), 2MWT (P = .006), and BBS (P = .003).

Conclusions:

  • Dalfampridine-ER reinitiation after a 10-day withdrawal period led to significant improvements in gait, walking speed, and distance.
  • The study demonstrates the efficacy of dalfampridine-ER in improving multiple functional mobility measures in MS patients.
  • The safety profile of dalfampridine-ER remained consistent with previous findings.