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Neurological Sciences

, Volume 40, Issue 1, pp 175–180 | Cite as

Effect of patients’ expectations on clinical response to fampridine treatment

  • Filipa LadeiraEmail author
  • Marcelo Mendonça
  • André Caetano
  • Manuel Salavisa
  • Henrique Delgado
  • Ana Sofia Correia
  • Miguel Viana-Baptista
Original Article
  • 31 Downloads

Abstract

Introduction

Patient expectation of treatment outcome is one of the primary mechanisms underlying the placebo effect. In multiple sclerosis trials with symptomatic treatments, a robust placebo effect is observed, which might be related to patient expectations. The aim of this study was to evaluate whether patient expectations regarding fampridine treatment influence the clinical response after 4 weeks and 6 months of treatment.

Materials and methods

We designed and carried out a prospective study from June 2015 to August 2017. Before treatment, patients completed a questionnaire including a scale evaluating their expectations regarding the treatment. The effect of baseline positive expectancy on the response status after 4 weeks and 6 months of treatment was analyzed through univariable and, when applicable, multivariable analysis.

Results

A total of 47 consecutive patients were included in the study. At week 4, 37 (78.7%) patients were classified as responders; a one-point increase in the positive expectancy questionnaire was significantly associated with a fourfold increase in the likelihood of being a responder [OR = 4.020 (95% CI 1.082–14.933); p = 0.038]. At 6 months, 43 patients completed follow-up. The number of responders decreased to 28; at this point, positive expectancy at baseline was no longer associated with response status.

Conclusion

Baseline positive expectancy regarding fampridine was determinant of the clinical response after 4 weeks of treatment. However, in the long term, fampridine efficacy was not dependent on expectations prior to treatment.

Keywords

Beliefs Expectations Fampridine Multiple sclerosis 

Notes

Compliance with ethical standards

Conflict of interest

Filipa Ladeira received travel support from Biogen, Teva, and Sanofi-Genzyme. Ana Sofia Correia received an educational sponsorship from Merck Serono; consulting and speaking fees from Novartis, Biogen Idec, and Merck; as well as research support from Biogen Idec and support for scientific meetings from Novartis, Biogen Idec, Sanofi Genzyme, Teva, and Bayer. Marcelo Mendonça, André Caetano, Manuel Salavisa, and Henrique Delgado have no conflicts of interest. Miguel Viana-Baptista received research support and travel grants from Sanofi-Genzyme.

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyHospital Egas Moniz, Centro Hospitalar de Lisboa OcidentalLisbonPortugal
  2. 2.CEDOC Nova Medical School/ Faculdade de Ciências MédicasUniversidade Nova de LisboaLisbonPortugal

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