Clinical Trial Design and Efficacy Data
AMPYRA® (dalfampridine) Extended Release Tablets is indicated as a treatment to improve walking in patients with multiple sclerosis (MS). This was demonstrated by an increase in walking speed.
AMPYRA® (dalfampridine) Extended Release Tablets study design in two randomized, well-controlled clinical trials
- Primary measure of efficacy was the prospective analysis of consistent response on walking speed as assessed by the T25FW
- Responder definition:
- Walking speed faster 3 of 4 visits during treatment than any maximum speed during 5 off-drug visits
Visit schedule and design for pivotal Trial 1
Visit schedule and design for pivotal Trial 2
Study schedules and design: After a screening visit for assessment of eligibility, patients returned at visit 0 and received single-blind placebo medication for 2 weeks. At visit 2, patients were randomly assigned to dalfampridine or placebo treatment, and returned for 4 visits (visits 3-6) over the course of the 9 or 14 weeks of double-blind treatment. Active treatment discontinued at visit 6 in Trial 1, and patients returned 2 and 4 weeks after treatment for follow-up visits 7 and 8. In Trial 2, visit 7 was an active treatment visit, but was not included in the efficacy assessment. This on-drug visit was used to determine dalfampridine plasma concentrations and to assess the duration of drug effect through the 12-hour dosing interval. Active treatment ended here and patients returned 2 weeks later for follow-up visit 8.
A Closer Look
- No differences in effectiveness were detected based on degree of impairment, age, gender, or body mass index.5
A Consistent Improvement in Walking
AMPYRA improved walking speed in significantly more patients than placebo in 2 pivotal clinical trials (34.8% vs. 8.3% and 42.9% vs. 9.3%), p<0.001 in both5,15
Two randomized, multicenter, double-blind, controlled Phase 3 studies of 21 and 14 weeks' duration.
In two randomized, well-controlled clinical trials:
- Patients responding to AMPYRA increased walking speed by approximately 25% from baseline in both trials as compared to 4.7% to 7.7% with placebo.6,15
Consistent Improvements in Walking Speed Were Clinically Meaningful
Consistent improvements in walking speed were shown to be associated with improvements on a patient self-assessment of ambulatory disability, the 12-item Multiple Sclerosis Walking Scale (MSWS-12).5
- A drug-placebo difference was not established for that outcome measure.5
- The MSWS-12 is a 12-item patient self-assessment of ambulatory disability.
Efficacy
Visit schedule and design for pivotal Trial 1
Efficacy
Visit schedule and design for pivotal Trial 2
Trial 1 Patient Selection15
Inclusion Criteria
- Men and women aged 18–70 years with definite MS
- Must be able to complete 2 trials of the Timed 25 Foot Walk (T25FW) at screening within 8–45 seconds
Exclusion Criteria
- History of seizures or epileptiform activity on EEG
- MS exacerbation within 60 days of screening
- Received corticosteroid within 30 days of screening
- Started immune modulator treatment within 90 days or change in dosing within 30 days
- Other clinically significant conditions that might affect study outcome
Trial 2 Patient Selection
Inclusion Criteria
- Men and women aged 18–70 years with definite MS
- Must be able to complete 2 trials of the Timed 25-Foot Walk (T25FW) at screening within 8–45 seconds
Exclusion Criteria
- History of seizures or epileptiform activity on EEG
- MS exacerbation within 60 days of screening
- Received corticosteroid within 30 days of screening
- Started immune modulator treatment within 90 days or change in dosing within 30 days
- Other clinically significant conditions that might affect study outcome
- In addition, patients with severe renal impairment were excluded from this trial
Inclusion and exclusion criteria were similar to those in Trial 1. In addition patients with severe renal impairment were excluded from this trial
Efficacy
AMPYRA improved walking speed in significantly more patients than placebo in 2 clinical trials (34.8% vs. 8.3% and 42.9% vs. 9.3%), p<0.001 in both5,15
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