Klara Novotna, Jana Lizrova Preiningerova, Lukas Sobisek and Eva Kubala Havrdova
Background: Gait impairment represents one of the most common symptoms of multiple sclerosis (MS). Fampridine is the first symptomatic treatment aimed at improving gait.
An objective measurement of the mobility improvement from treatment initiation has been recommended to evaluate treatment response.
Objective: In this retrospective observational study, we evaluated what improvement in walking speed can be expected in people with multiple sclerosis (MS) treated with Fampridine in clinical practice, with respect to specific disability levels (EDSS 4.0-7.0).
Methods: The mobility tests including the Timed 25 foot walk test (T25FW), Timed Up and Go test (TUG) and Step test (ST) were performed just before and 3 h after administration of Fampridine 10 mg tablet.
Results: One hundred and thirty one (131) people with MS (15 with primary progressive, 40 with secondary progressive and 76 people with relapsing-remitting MS). The mean age was 48 years (SD 9.8), mean MS duration was 19, 8 years, 58% were women. The range of treatment response of Fampridine, measured with the T25FW test, varied from 11-41%.
Contrary to prior reports, the baseline T25FW and the percentage of improvement in T25FW was significantly correlated.
Conclusion: Assessment of treatment response outside of a clinical trial is challenging and may require different outcome measures compared to RCT. For MS patients with moderate disability seems TUG test or Step test more appropriate for quantifying treatment response.