"Effectiveness and associated factors of response to Fampridine in multiple sclerosis: A prospective observational...

To evaluate the effectiveness of fampridine on gait performance in patients with multiple sclerosis (MS) and to identify clinical predictors of therapeutic response.

Prospective observational study of 197 MS consecutive patients with walking impairment (EDSS 4.0-7.00) treated with fampridine between 2018 and 2024. Gait was assessed using the Timed 25-Foot Walk (T25FW), 2-Minute Walk Test (2MWT), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12) at five timepoints over a 12-month follow-up. Responders were defined as those with ≥20 % improvement in T25FW or ≥6-point reduction in MSWS-12. A multivariable logistic regression was performed to identify independent predictors of response.

Significant improvements were observed across all gait measures (p < 0.001) in the follow-up visits. Male sex (OR=2.375; p = 0.018) and higher baseline MSWS-12 scores (OR=1.141; p = 0.001) were associated with increased likelihood of response. Older age (OR=0.962; p = 0.028) and higher baseline EDSS (OR=0.356; p < 0.001) were associated with reduced probability of response. Fampridine was well tolerated, with a 33 % discontinuation rate at the end of follow-up, mainly due to perceived lack of benefit.

Fampridine significantly improves gait performance in MS patients in real-world settings. Simple clinical variables such as age, sex, EDSS, and subjective walking impairment (MSWS-12) may help identify individuals most likely to benefit from treatment.