Goodman Andrew D, Brown Theodore R, Schapiro Randall T, Klingler Michael, Cohen Ron, Blight Andrew R
Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA (ADG); Evergreen Hospital Medical Center, Kirkland, WA, USA (TRB); Minneapolis Clinic of Neurology, Minneapolis, MN, USA (RTS); and Acorda Therapeutics, Inc., Ardsley, NY, USA (MK, RC, ARB).
Int J MS Care. 2014 Fall;16(3):153-60. doi: 10.7224/1537-2073.2013-023.
Two phase 3 clinical trials demonstrated that dalfampridine extended-release 10-mg tablets (D-ER), twice daily, significantly improved walking relative to placebo in patients with multiple sclerosis (MS). The objective of this study was to evaluate the efficacy and safety of D-ER in patients with MS using pooled data from the two phase 3 trials.
Data were pooled from the two trials, and D-ER was compared with placebo for timed-walk responder rate, changes in walking speed, and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Response rates were evaluated with respect to demographic and clinical characteristics.
D-ER had a significantly higher proportion of timed-walk responders relative to placebo (37.6% vs. 8.9%; P < .0001). The responder rate was independent of age, gender, race, body-mass index, type of MS, duration of MS, baseline Expanded Disability Status Scale score, baseline walking speed, and concomitant use of immunomodulatory therapies. Significant improvements were observed in walking speed and in MSWS-12 score for the pooled D-ER group compared with placebo. The safety profile was consistent with the individual studies; no new safety or tolerability concerns were identified.
D-ER demonstrated efficacy for the improvement of walking in patients with MS; response was independent of demographic and clinical characteristics.
两项3期临床试验表明,对于患有多发性硬化症(MS)的患者,每日两次服用10毫克缓释达氟吡啶(D-ER)片相对于安慰剂能显著改善行走能力。本研究的目的是使用两项3期试验的汇总数据评估D-ER对MS患者的疗效和安全性。
汇总两项试验的数据,将D-ER与安慰剂在定时行走反应率、步行速度变化以及12项多发性硬化症步行量表(MSWS-12)方面进行比较。根据人口统计学和临床特征评估反应率。
相对于安慰剂,D-ER的定时行走反应者比例显著更高(37.6%对8.9%;P <.0001)。反应率与年龄、性别、种族、体重指数、MS类型、MS病程、基线扩展残疾状态量表评分、基线步行速度以及免疫调节疗法的联合使用无关。与安慰剂相比,汇总的D-ER组在步行速度和MSWS-12评分方面有显著改善。安全性概况与个体研究一致;未发现新的安全性或耐受性问题。
D-ER证明对改善MS患者的行走能力有效;反应与人口统计学和临床特征无关。