PR Fampridine improves patient reported upper limb function in people with MS measured by ABILHAND
Author(s): ,
J. Johnson
Affiliations:
National Hospital for Neurology & Neurosurgery, London, United Kingdom
,
K. Bull
Affiliations:
National Hospital for Neurology & Neurosurgery, London, United Kingdom
,
N. Hare
Affiliations:
National Hospital for Neurology & Neurosurgery, London, United Kingdom
,
K. Phillips
Affiliations:
National Hospital for Neurology & Neurosurgery, London, United Kingdom
R. Farrell
Affiliations:
National Hospital for Neurology & Neurosurgery, London, United Kingdom
ECTRIMS Online Library. Johnson J. Oct 12, 2018; 229122; P1282
Jo Johnson
Jo Johnson
Contributions
Abstract

Abstract: P1282

Type: Poster Sessions

Abstract Category: Therapy - Others

Background: PR Fampridine is licenced for walking impairment, response is apparent within 2 weeks. Recent clinical trials (ENHANCE) and cohort studies suggest other benefits including upper limb function particularly in those EDSS ≥ 6.0.
Aim: To evaluate the effect of PR-Fampridine on patient reported hand function using the 23 item ABILHAND.
Methodology: A prospective cohort study of subjects attending the multidisciplinary MS walking service at the NHNN, London UK was performed. Data included baseline demographics, EDSS, MS type, timed 25 foot walk (T25FW), MS walking scale 12 (MSWS12), health-related quality of life using the EuroQol 5-dimension instrument, 5-level version (EQ-5D-5L), 23 item ABILHAND and goals were set. Subjects were assessed twice prior to treatment with PR-Fampridine and reviewed after 2 weeks. Responders were defined as those whose T25FW improved by ≥ 20% compared to baseline. Data was analysed using paired t-test and cohen's d for effect size. ABILHAND was evaluated using logit scale.
Results: 48 subjects completed ABILHAND questionnaires at baseline at two weeks. Mean age 53 [19-75], mean EDSS 6.5 [5.5 - 7], MS type: SPMS: 20, PPMS: 11, RRMS: 17. There was significant improvement on ABILHAND at 2 weeks (baseline 1.13 [-2.8 - 5.9], at 2 weeks 1.7 [-2.8- 6]), mean change 0.58, d=0.26, p=0.003. Excluding 14 subjects with no response, mean ABILHAND (n=34) at baseline was baseline 0.8, effect size increased to 0.5 p< 0.0001. Twenty subjects completed 16 weeks treatment, mean change 0.7 d=0.4 p=0.0005. Thirty nine (80%) were T25FW responders. Of the T25FW non responders 4 reported significant benefit on ABILHAND.
Conclusions: There is no accepted minimal clinically important difference ABILHAND in MS however effect size of 0.26 is clinically relevant in stroke. PR-Fampridine shows patient reported benefit in hand function over a short time period. Those with existing upper limb dysfunction were more likely to respond. Using the medication within license for walking precludes access to non-ambulant subjects. Further assessment of the clinical benefit of PR-Fampridine in people with advanced MS is required.
Disclosure: R. Farrell has received honoraria / consultant fees from GW Pharma, Canbex Pharmaceuticals Ltd, Biogen Idec, Merck, Allergan PLC. R Farrell is supported by the NIHR UCL Biomedical Research Centre, Jo Johnson: Nothing to disclose, Kate Bull: nothing to disclose, Kate Phillips: Nothing to disclose, Nicola Hare: Nothing to disclose

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