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Efficacy of Dalfampridine on Upper Extremity Function in Patients With MS

Phase 4
Conditions
Multiple Sclerosis
Interventions
Registration Number
NCT02259361
Lead Sponsor
Sheba Medical Center
Brief Summary

This study evaluates the effects of sustained-release oral dalfampridine in the treatment of upper limb deficits in people with multiple sclerosis (MS). In this double-blind randomized pilot study half of participants will dalfampridine, while the other half will receive a placebo.

Detailed Description

Dalfampridine (ampyra), a drug with a mechanism for symptomatic management of MS among blocks potassium channels on demyelinated neurons, allows normal electrical conduction.

Dalfampridine has recently been found to be associated with improvements in visual function, strength, ambulation, fatigue, and endurance in individuals with MS.

Although this medication has a widespread effect, its influence on upper extremity function has never been investigated in a double blind randomized case control study.

Following the fact that during the disease course, approximately 3 out of 4 multiple sclerosis patients encounter upper limb dysfunction the primary objective of this study will be to investigate the efficacy of sustained-release oral dalfampridine on upper extremity function in patients with MS.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  1. The patient must have the ability to understand the purpose and risks of the study provide a signed and dated informed consent and authorize confidential health information to be examined in accordance with national and local subject privacy regulations.
  2. The patient must have been diagnosed with clinically definite MS, at the time of informed consent.
  3. The patient must be between 18-70 years of age, inclusive, at the time of informed consent.
  4. The patient must have scored between 50 and 90 on the upper limb Motricity Index test, at the time of informed consent. This test evaluates strength during three essential movements (pinch grasp, elbow flexion and shoulder abduction). The selected score range criteria determine patients who suffer a moderate decline in function abilities of the upper limb.
Exclusion Criteria
  1. Onset of multiple sclerosis exacerbation within 60 days of screening.
  2. History of seizures or evidence of epileptic form activity found on a screened electroencephalogram.
  3. Changes in concomitant medications to avoid related changes in multiple sclerosis symptoms during the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ExperimentalSustained-release oral dalfampridineIntervention: Sustained-release oral dalfampridine, one 10 mg tablet, twice daily, taken 12 hours apart (one tablet in the morning and one tablet in the evening) for 14 consecutive days.
PlaceboPlaceboPlacebo, one 10 mg tablet, twice daily, taken 12 hours apart (one tablet in the morning and one tablet in the evening) for 14 consecutive days.
Primary Outcome Measures
NameTimeMethod
Nine-Hole Peg TestChanges in the Nine-Hole Peg Test from end of second week to follow up 2-weeks after end of intervention phase

The Nine-Hole Peg Test is a brief, standardized, quantitative test of upper extremity function

Secondary Outcome Measures
NameTimeMethod
Box and Block testChanges in the Box and Block Test from end of second week to follow up 2-weeks after end of intervention phase

The box and blocks test (BBT) examines manual dexterity

Sensory evaluationChanges in the Sensory evaluation Test from end of second week to follow up 2-weeks after end of intervention phase

The two-point discrimination test will be used to determine tactile sensation. Light-touch and pressure-sensation thresholds will be determined using monofilaments

Isometric grip force and motor fatigueChanges in the Isometric grip force and motor fatigue tests from end of second week to follow up 2-weeks after end of intervention phase

Peak isometric grip force (in NM) and isometric fatigue index will be determined by a hand-held dynamometer (Biometrics Ltd.,USA). The hand-held dynamometer is a medical device used to assess grip strength in functional assessment and in initial and ongoing evaluation of patients with hand dysfunction

Patient rating scale - Disabilities of the Arm, Shoulder and Hand (DASH)Changes in the DASH Test from end of second week to follow up 2-weeks after end of intervention phase

The DASH (http://www.dash.iwh.on.ca/) has 30 items grouped into one scale aiming to measure 'physical function and symptoms' in people with disorders of the upper limb.15 Items are scored from 1 (no difficulty) to 5 (unable). A total 'disability/symptom' score is generated by summing items, and averaging to produce a mean item score between 1 and 5

Trial Locations

Locations (1)

Multiple Sclerosis Center

🇮🇱

Tel-hashomer, Ramat-gan, Israel

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