4-Aminopyridine is superior to 3,4-diaminopyridine in the treatment of patients with multiple sclerosis.

Abstract

OBJECTIVE:

To compare the efficacy and toxicity of 4-aminopyridine and 3,4-diaminopyridine in patients with multiple sclerosis.

DESIGN:

Intervention study with a before-after design and a randomized, double-blind, crossover design.

SETTING:

University referral center.

PATIENTS:

Twenty-four patients with definite multiple sclerosis who had been treated in a previous clinical trial with 4-aminopyridine.

INTERVENTIONS:

Nonresponders to treatment with 4-aminopyridine (14 patients) were treated with 3,4-diaminopyridine in a 4-week, open-label trial with doses up to 1.0 mg/kg of body weight (before-after design). Responders to treatment with 4-aminopyridine (10 patients) participated in a comparative study of 6 weeks' duration with 4-aminopyridine and 3,4-diaminopyridine according to a randomized, double-blind, double-crossover design.

MAIN OUTCOME MEASURES:

Neurophysiologic variables for nonresponders, neurologic functions and symptoms on a visual analogue scale for responders, and side effects for both groups.

RESULTS:

Toxicity profiles of 4-aminopyridine and 3,4-diaminopyridine were different, and systemic tolerability was reduced for 3,4-diaminopyridine. 4-Aminopyridine was more effective than 3,4-diaminopyridine, especially for ambulation, fatigue, and overall daily functioning.

CONCLUSION:

Our data suggest that, concerning both efficacy and side effects, 4-aminopyridine is superior to 3,4-diaminopyridine in the treatment of patients with multiple sclerosis.

• Authors: C H Polman, F W Bertelsmann, R de Waal, H A van Diemen, B M Uitdehaag, A C van Loenen, J C Koetsier
• Journal: Archives of neurology (Arch Neurol) Vol. 51 Issue 11 Pg. 1136-9 (Nov 1994) ISSN: 0003-9942 [Print] United States
• PMID: 7980110 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Placebos
• 4-Aminopyridine
• Amifampridine

Topics

• 4-Aminopyridine (adverse effects, analogs & derivatives, therapeutic use)
• Adult
• Aged
• Amifampridine
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Multiple Sclerosis (drug therapy)
• Placebos