4-Aminopyridine improves pulmonary function in quadriplegic humans with longstanding spinal cord injury.

Abstract

STUDY OBJECTIVE:

To test the hypothesis that 4-aminopyridine (4-AP) might cause clinically evident improvement in pulmonary function in humans with chronic spinal cord injury (chronic SCI).

DESIGN:

Balanced, open-label study with subjects consecutively enrolled.

SETTING:

Spinal Cord Injury Service, university-affiliated tertiary level care Department of Veterans Affairs Medical Center.

PATIENTS:

Seventeen healthy men and women suffering from traumatic SCI (11 quadriplegic, 6 paraplegic patients) for more than 1 year.

INTERVENTIONS:

Each subject was given a single dose of 4-AP 10 mg orally in an immediate-release formulation.

MEASUREMENTS AND MAIN RESULTS:

Significant increases in mean values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) that persisted for at least 12 hours were demonstrated in quadriplegic patients beginning 6 hours after 4-AP administration. Tests of pulmonary function that demonstrated statistically significant increases at any time were also numerically, if not statistically, increased at 24 hours compared with pretreatment values obtained in 4-AP-naive subjects.

CONCLUSIONS:

The administration of a single dose of an immediate-release formulation of 4-AP to humans with longstanding, traumatic quadriplegia is associated with sustained, clinically meaningful, and statistically significant improvements in pulmonary function. We suggest that the administration of 4-AP may have a salutary effect in patients suffering from SCI and appears to be associated with potentially clinically significant reductions in the pathophysiologic pulmonary sequelae of SCI.

• Authors: J L Segal, S R Brunnemann
• Journal: Pharmacotherapy (Pharmacotherapy) 1997 May-Jun Vol. 17 Issue 3 Pg. 415-23 ISSN: 0277-0008 [Print] United States
• PMID: 9165545 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Potassium Channel Blockers
• 4-Aminopyridine

Topics

• 4-Aminopyridine (therapeutic use)
• Adult
• Chronic Disease
• Female
• Humans
• Male
• Middle Aged
• Paraplegia (etiology, physiopathology)
• Potassium Channel Blockers
• Quadriplegia (etiology, physiopathology)
• Respiratory Function Tests
• Respiratory Paralysis (drug therapy, etiology, physiopathology)
• Spinal Cord Injuries (complications, physiopathology)