Crayton H, Sidovar M, Wulf S, Guo A. Patient Perspectives and Experience with Dalfampridine Treatment in Multiple Sclerosis-Related Walking Impairment: The Step Together Program.
Patient. 2014 Dec. [Epub ahead of print]
BACKGROUND:Dalfampridine extended-release tablets (dalfampridine-ER; in Europe, prolonged-release fampridine, and elsewhere, fampridine modified or fampridine sustained release), 10 mg twice daily, are available for the treatment of improvement of walking in patients with multiple sclerosis, as demonstrated by an increase in walking speed. On-drug patient perspectives and experiences are valuable to understand and manage this patient population.
OBJECTIVE:The objective of this study was to examine perspectives and experiences of patients receiving dalfampridine-ER in a real-world setting.
METHODS:Step Together, an ongoing program that captures real-world patient experience with dalfampridine-ER treatment, consists of a survey administered at baseline (before dalfampridine-ER initiation) and at 30 (first follow-up) and 60 days (second follow-up) after initiation. The survey includes modified versions of the 12-item Multiple Sclerosis Walking Scale (mMSWS-12) and the Sheehan Disability Scale (mSDS) to assess walking ability and functional impairment, respectively.
RESULTS:As of September 2013, 2,248 patients participated in the baseline survey and 522 completed both follow-up surveys (completers). Among the completers, improvements in walking ability and function relative to baseline were significant at both follow-ups as measured by mMSWS-12 and mSDS scores, respectively. Notably, 69-74 % of completers at both follow-ups had improved mMSWS-12 scores, with scores greater than the range considered to be minimally clinically significant. Patients who completed the program expressed satisfaction with overall dalfampridine-ER treatment, and 69 % indicated that the survey would help them communicate better with their healthcare providers.
CONCLUSION: Results highlight the utility of patient-reported outcomes in the assessment of patient perspective and experience, providing a useful supplement to traditional objective measures used in clinical studies.
The trials indicated that about a 30-90% of people may benefit from taking fampridine for improvement in walking. The best way to determine if fampridine is of benefit is to try it. In this study of real-world MSers about two/thirds of the respondents claimed benefit.