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Τετάρτη 25 Απριλίου 2018

Impact of fampridine on quality of life: clinical benefit in real-world practice

Objectives

To assess the effectiveness and tolerability of fampridine in patients with multiple sclerosis (MS) in real clinical practice and to analyse adherence to treatment and general satisfaction of patients in terms of quality of life (QOL).

Methods

Patients who started treatment with fampridine from May 2014 to October 2014 were included. Primary and secondary outcomes were Timed 25-Foot Walk (T25FW) and MS Walking Scale-12 (MSWS-12) respectively, measured at baseline and 2 weeks, 3 and 6 months. Adherence was measured by the Morisky–Green questionnaire, patient satisfaction with a visual analogue scale (VAS) and QOL with improvement in mobility, self-care, daily activities, pain/discomfort or anxiety/depression.

Results

30 patients (46.7% women) of mean age 39 years, mean MS duration 13.7 years, mean Expanded Disability Status Scale score 5.8, 57% with relapsing-remitting MS were included. 22 patients (73%) continued to take treatment throughout the study period. Two weeks after treatment initiation all measures improved significantly from baseline (T25FW: –7.5 s, p<0.05; MSWS-12: –36.7, p<0.05). At 6 months, walking speed and self-perceived walking ability were significantly improved (T25FW: –3.8 s, p<0.05; MSWS-12: –30.0, p<0.05). Adverse events were reported by 30% of patients. Seizures were registered in one patient. 70% of patients were adherent with treatment. Median (IQR) general satisfaction VAS score was 8 (7–9). Patients reported an improvement in mobility (70%), anxiety/depression (33.3%), self-care (23.3%), daily activities (23.3%) and pain/discomfort (3.3%).

Conclusions

Fampridine is effective and safe in patients with MS in real clinical practice up to 6 months. Adherence to treatment was suboptimal but patients' general satisfaction was high and fampridine improved several items of QOL.



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