Positive effects of fampridine on cognition, fatigue and depression in patients with multiple sclerosis over 2 years
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To assess the effects of PR-fampridine on cognitive functioning, fatigue and depression in patients with multiple sclerosis (PwMS).
Thirty-two PwMS were included in this trial. Cognitive performance was assessed in an open-label and randomized double-blind, placebo-controlled study design using a comprehensive neuropsychological test battery as well as questionnaires examining depression and fatigue.
We found significant improvements in cognitive measures assessing alertness (tonic alertness, p = 0.0244 and phasic alertness, p = 0.0428), psychomotor speed (p = 0.0140) as well as verbal fluency (p = 0.0002) during open-label treatment with PR-fampridine. These effects of performance were paralleled by patients’ perception of reduced fatigue (physical, p = 0.0131; cognitive, p = 0.0225; total, p = 0.0126). Fampridine-induced improvements in phasic alertness (p = 0.0010) and measures of fatigue (physical, p = 0.0014; cognitive, p = 0.0003; total, p = 0.0005) were confirmed during randomized, double-blind, placebo-controlled assessment in the second year. In addition, we found positive effects of PR-fampridine on depressive symptoms (p = 0.0049). We demonstrated persisting beneficial effects of PR-fampridine on fatigue in PwMS over a period of more than 2 years. Drug responsiveness regarding cognitive performance and fatigue was not limited to walking responders.
Our data demonstrate significant positive effects of treatment with PR-fampridine over 2 years on different cognitive domains as well as fatigue and depression in a cohort of PwMS. These findings imply that PR-fampridine should be considered as symptomatic treatment improving aspects of cognition, fatigue and depression in PwMS.
KeywordsMultiple sclerosis PR-fampridine Dalfampridine Cognition Fatigue Depression
We thank the subjects who participated in this study and the institutions supporting the trial (Betty and David Koetser Foundation, the Clinical Research Priority Program (CRPP) “NeuroRehab” of the University of Zurich, the Swiss MS Society and Biogen).
Compliance with ethical standards
Conflicts of interest
Dr. Zörner received honoraria, travel grants and funding from Biogen. Prof. Linnebank received honoraria, travel grants and funding from Biogen. He is a consultant to Biogen.
This study was approved by the cantonal ethics committee Zurich, Switzerland, and the regulatory agency for medicines (Swissmedic), and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.
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