Assessment of confirmed urinary tract infection in patients treated with dalfampridine for multiple sclerosis

Kantor, Daniel; Chancellor, Michael B.; Snell, Clayton W; Henney, Herbert R.; Rabinowicz, Adrián L.

doi:10.1080/00325481.2015.1000229

Cited by 10 publications

(10 citation statements)

References 18 publications

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“…Concerning urinary symptoms, most of the studies reported detrusor overactivity. This is in line with a previous study showing that under fampridine treatment only 30% of patients with urinary symptoms have an infection [43].…”

Section: Discussionsupporting

confidence: 81%

Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review

Lecat¹,

Decavel²,

Magnin³

et al. 2017

Eur Neurol

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Background: Gait impairment is one of the most disabling symptoms in people with multiple sclerosis (PwMS). Fampridine, has demonstrated a positive effect on gait speed in PwMS after 14 days of treatment but the long-term effects have not yet been demonstrated. This study reviews the long-term effects of fampridine on gait in PwMS. Summary: This systematic review was conducted according to the PRIS-MA statement. Studies were considered long term if treatment exceeded 28 days. From the 498 studies identified, 18 (2,200 patients) fulfilled all eligibility criteria. Only 3 studies followed-up patients for >1 year and one of these showed a non-significant improvement in the gait speed. Key Messages: Fampridine seems to be beneficial at improving gait speed in PwMS in the long term. Further long-term studies are needed on related gait and functional parameters.

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Section: Discussionsupporting

confidence: 81%

Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review

Lecat¹,

Decavel²,

Magnin³

et al. 2017

Eur Neurol

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“…Ineffectiveness or inappropriate dosing count as well, and also anaphylactic reactions and seizures in rare cases. Adverse events might also include urinary tract infections (UTI), but there are studies that found similar results concerning the risk for UTI within dalfampridine patients and placebo groups (31,32). Two of our patients experienced dizziness in the beginning of the study as the only adverse event, however, with amelioration within the first week.…”

Section: Discussionsupporting

confidence: 59%

Assessment of motor outcomes in multiple sclerosis patients with walking impairment treated with Fampridine using motor evoked potentials

Trofin

Ignat

et al. 2019

Preprint

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Backgound : the purpose of the study is to consider the utility of Transcranial Magnetic Stimulation (TMS) in patients with Multiple Sclerosis (MS) and walking impairment, treated with Fampridine, as correlated with the 25-Foot-Walk test (T25-FW). It is known that clinical benefits should be identified within two to four weeks after starting the treatment; otherwise, if there is no benefit reported by patients, it should be discontinued. Methods: 15 MS patients with walking impairment, ranked between 3.5 and 7 on the Expanded Disability Status Scale (EDSS), were investigated by T25-FW and TMS. Evaluations were performed prior to Fampridine 10 mg twice daily administration, 5 and 12 days afterwards, and also 1 and 3 months later. The medium age was 42.8 years and an average duration of the disease was 12.06 years. Results: we assessed an improvement of walking by 2.1 seconds measured on the T25-FW after the first 12 days in 9 patients, which correlated with a 2 miliseconds improvement of the Central Motor Conduction Time (CMCT). For the other 6 patients there was no visible clinical improvement. Nevertheless, CMCT dropped by 0.5 ms and the motor conduction speed by 1 millisecond in 4 of these 6 patients. Fampridine administration was continued in the 4 cases. At the end of the 3 months period, their walking speed measured as on the T25-FW also improved by 2 sec. Conclusions: the amelioration of TMS parameters anticipated the improvement of speed on the T25-FW. In spite of the early false negative clinical response, electrophysiological findings could predict a future clinical improvement if treatment is continued.

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“…The use of Dmannose seems to be associated with a reduction in the number of UTIs. Rakusa et al, 2012;Kantor et al, 2015;Jahromi et al, 2014;Mahadeva et al, 2014Marrie et al, 2014Manack et al, 2011;Jick et al, 2015;Phé et al, 2016;Salinas-Casado et al, 2019. EAU guidelines, 2020Fowler et al;Rakusa et al, 2012Rakusa et al, 2012Clark and Welk, 2018;Shigemura et al, 2015;Jahromi et al, 2014Hossain et al, 2018Jahromi et al, 2014Jahromi et al, 2014.…”

Section: Resultsmentioning

confidence: 99%

“…Infections, whether in the urinary tract or elsewhere, can precipitate outbreaks, worsen the disease, causing more damage and a severe deterioration of the neurological condition (Rakusa et al, 2012;Kantor et al, 2015). Immune response activation is a possible explanation, which negatively affects the disease, worsening the stable condition (Maghzi et al, 2012).…”

Section: The Relationship Between Uti and Ms Outbreaksmentioning

confidence: 99%

“…It often presents complications resulting from partial remission after an outbreak, with one of the possible complications being bladder dysfunction, affecting 50-80% of patients (Gallien et al, 2014), and in 70% of these patients, the urinary symptoms will progress according to the functional and neurological deterioration (DeLong et al, 2011). The most common symptoms are: urinary urgency, polyuria, nocturia, urinary retention and incontinence (Kantor et al, 2015;Tudor et al, 2016), and the presence of Urinary Tract Infections (UTI) in MS patients is closely related to the difficulty of these patients in having their bladder empty (Holland et al, 2012;Holland et al, 2016;Sand et al, 2013). However, according to Kapica-Topczewska and colleagues, of 815 MS patients of northeastern Poland, 39% had urinary incontinence (an important risk factor for UTI development) and 3.5% had UTI (Kapica-Topczewska et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Urinary Tract Infection in Patients with Multiple Sclerosis: An Overview

Medeiros¹,

Demore²,

Mazaro³

et al. 2020

Preprint

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Introduction: Multiple sclerosis (MS) is a demyelinating, chronic, inflammatory and autoimmune disease of the central nervous system (CNS) with axonal degeneration, presenting a progressive and variable course. MS patients usually have complications, such as bladder dysfunction, presence of urinary symptoms and Urinary Tract infection (UTI), which is one of the three most common non-neurological complications in MS patients. Objective: Analyze the most diverse aspects of UTI in MS patients, focusing on risk factors, prevalence, hospitalization and mortality rates of UTIs in this group. Methods: A non-systematic review of articles published on PubMed in the last 10 years with the search terms "Urinary Tract Infection" AND "Multiple Sclerosis". Discussion: MS patients have a high UTI prevalence, mainly due to the occurrence of urinary disorders in these patients. The most common symptoms of UTI in MS patients are urinary urgency, polyuria, nocturia, urinary retention, and incontinence. Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most found organisms and treatment is based on antibiotic therapy. Moreover, UTIs can precipitate outbreaks, worsen the disease, causing more damage and a severe neurological condition deterioration. Therefore, UTIs in this group are associated with a high hospitalizations rate and a high mortality rate. Conclusion: UTI represents a great risk and concern in MS patients. The high prevalence, hospitalization rate and mortality rate of UTI in MS is worrying, such as the cause-consequence relationship between UTIs and the use of corticosteroids in outbreaks. Therefore, it is important to be aware of a UTI in this group to make early diagnoses, adequate management, and new infections prevention. Thus, further studies are needed to thoroughly analyze each nuance of this important comorbidity for MS patients.

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Assessment of confirmed urinary tract infection in patients treated with dalfampridine for multiple sclerosis

Cited by 10 publications

References 18 publications

Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review

Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review

Assessment of motor outcomes in multiple sclerosis patients with walking impairment treated with Fampridine using motor evoked potentials

Urinary Tract Infection in Patients with Multiple Sclerosis: An Overview

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