48 Participants Needed

Dalfampridine + Physical Therapy for Multiple Sclerosis

(AmpPT Trial)

JC
PP
PP
Overseen ByPrudence Plummer, PhD, PT
Age: 18+
Sex: Any
Trial Phase: Phase 4
Sponsor: MGH Institute of Health Professions
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to evaluate if combining a medication that can help improve walking in people with multiple sclerosis (MS) with a physical therapy program is better for improving walking than either treatment alone. The main questions this study will answer are: * Does combining dalfampridine with physical therapy improve mobility more than physical therapy without concurrent dalfampridine? * Is the combined treatment associated with better outcomes than the medication (dalfampridine) on its own? * How do the individual treatments (dalfampridine, physical therapy) alone compare to each other? Participants with MS-related mobility deficits will: * Receive 6 weeks of dalfampridine treatment to assess the effects of this treatment. * After stopping the medication for 2 weeks, the investigators will re-evaluate walking, then randomly assign individuals to a 6-week physical therapy program. * Half of the participants will receive physical therapy while resuming dalfampridine treatment. The other half of the participants will receive physical therapy without resuming the medication. Researchers will compare the combination treatment group (medication plus physical therapy) to the physical therapy only group to see if the combined treatment improves walking-related function. Approximately 3 months after finishing the physical therapy program, participants will undergo a final evaluation to see if the treatment effects have been maintained.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot be currently taking dalfampridine or have stopped it due to side effects. You will need to stop dalfampridine for 2 weeks during the trial.

What data supports the effectiveness of the drug dalfampridine combined with physical therapy for improving mobility in people with multiple sclerosis?

Research shows that dalfampridine, when combined with physical therapy, may improve walking speed in people with multiple sclerosis more than physical therapy alone. In a small study, participants taking dalfampridine and doing physical therapy improved their walking speed by about 20.7%, compared to 10.8% for those only doing physical therapy.12345

Is the combination of Dalfampridine and Physical Therapy safe for humans?

Dalfampridine, also known as Ampyra or Fampridine, is generally well tolerated but may increase the risk of seizures, especially in people with kidney problems. Common side effects include urinary tract infections, insomnia, headache, and dizziness. It is important to avoid use in individuals with a history of seizures.46789

How does the treatment of Dalfampridine combined with physical therapy differ from other treatments for multiple sclerosis?

This treatment is unique because it combines Dalfampridine, a drug that helps improve walking by blocking potassium channels in nerve cells, with physical therapy to enhance mobility in people with multiple sclerosis. The combination aims to improve walking speed more effectively than either treatment alone.12478

Research Team

PP

Prudence Plummer, PhD, PT

Principal Investigator

MGH Institute of Health Professions

Eligibility Criteria

This trial is for people with MS who can walk a bit but have trouble with mobility. They should be able to stand on their own and understand instructions, haven't had a relapse in 3 months, and aren't currently on dalfampridine or physical therapy. People with other conditions affecting movement, recent hospital stays, uncontrolled blood pressure or diabetes, history of seizures, kidney issues, or women who are pregnant can't join.

Inclusion Criteria

I have been free from cancer relapse for at least 3 months.
My cognitive function is relatively good.
I am not currently on dalfampridine and have never stopped it due to side effects.
See 5 more

Exclusion Criteria

Unable to follow a 3-step verbal command in English
I have a history of seizures.
Women who are breastfeeding, pregnant, or trying to become pregnant
See 5 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Dalfampridine Treatment

Participants receive 6 weeks of dalfampridine treatment to assess the effects of this treatment

6 weeks
Regular visits for monitoring

Washout and Re-evaluation

Participants stop dalfampridine for 2 weeks and undergo re-evaluation of walking

2 weeks

Physical Therapy with/without Dalfampridine

Participants are randomly assigned to 6 weeks of physical therapy with or without resuming dalfampridine

6 weeks
Twice per week for physical therapy

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 weeks
Final evaluation approximately 3 months after physical therapy

Treatment Details

Interventions

  • Dalfampridine
  • Physical therapy
Trial Overview Researchers are testing if taking the drug dalfampridine along with physical therapy helps improve walking more than just one treatment alone. Participants will first take the medication for six weeks then stop for two before starting a six-week physical therapy program where half will also resume the medication.
Participant Groups
3Treatment groups
Active Control
Group I: Physical therapyActive Control1 Intervention
One-on-one outpatient physical therapy twice per week
Group II: Dalfampridine onlyActive Control1 Intervention
10 mg tablet twice per day
Group III: Dalfampridine plus physical therapyActive Control1 Intervention
10 mg tablet twice per day while receiving one-on-one outpatient physical therapy twice per week

Dalfampridine is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Ampyra for:
  • Improvement of walking in adults with multiple sclerosis
🇪🇺
Approved in European Union as Fampyra for:
  • Improvement of walking in adults with multiple sclerosis

Find a Clinic Near You

Who Is Running the Clinical Trial?

MGH Institute of Health Professions

Lead Sponsor

Trials
19
Recruited
2,200+

Findings from Research

In a study involving 8 individuals with multiple sclerosis, those taking dalfampridine showed a 12.8% improvement in gait speed during a 3-week baseline period, suggesting the drug may enhance mobility.
After 6 weeks of physical therapy, participants taking dalfampridine experienced a greater average improvement in gait speed (20.7%) compared to those not on the medication (10.8%), indicating that combining dalfampridine with physical therapy may be more effective for improving mobility in MS patients.
Dalfampridine for Mobility Limitations in People With Multiple Sclerosis May Be Augmented by Physical Therapy: A Non-randomized Two-Group Proof-of-Concept Pilot Study.Plummer, P., Markovic-Plese, S., Giesser, B.[2022]
In a study of 52 multiple sclerosis patients, dalfampridine significantly improved walking ability and reduced motoric and cognitive fatigue within just 2 weeks of treatment, with these benefits lasting up to 9-12 months.
After 9-12 months, improvements in cognitive function, specifically measured by the PASAT test, were also observed, indicating that dalfampridine has both short- and long-term positive effects on mobility and cognitive performance in MS patients.
Long-term effects of dalfampridine in patients with multiple sclerosis.Ruck, T., Bittner, S., Simon, OJ., et al.[2022]
Dalfampridine has been shown to improve walking speed in individuals with multiple sclerosis based on three recent randomized controlled trials, indicating its potential efficacy as a treatment.
However, the effectiveness of dalfampridine varies among patients, and there is currently no clear method to identify which patients will benefit significantly from the treatment.
Assessing dalfampridine efficacy in the physician's office.Raffel, JB., Malik, O., Nicholas, RS.[2013]

References

Dalfampridine for Mobility Limitations in People With Multiple Sclerosis May Be Augmented by Physical Therapy: A Non-randomized Two-Group Proof-of-Concept Pilot Study. [2022]
Long-term effects of dalfampridine in patients with multiple sclerosis. [2022]
Assessing dalfampridine efficacy in the physician's office. [2013]
Development of dalfampridine, a novel pharmacologic approach for treating walking impairment in multiple sclerosis. [2014]
A phase 3 trial of extended release oral dalfampridine in multiple sclerosis. [2022]
Dalfampridine prior authorization program: a cohort study. [2023]
Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. [2022]
Dalfampridine in multiple sclerosis. [2017]
Extended-release dalfampridine in the management of multiple-sclerosis-related walking impairment. [2021]
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