Trial reportNeurology2013
Effect of 4-aminopyridine on vision in multiple sclerosis patients with optic neuropathy.
Trial report in Neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Effects of Fampridine in People with Multiple Sclerosis: A Systematic Review and Meta-analysis.CNS drugs · 2019Pooled it
- Clinical features of MS associated with Leber hereditary optic neuropathy mtDNA mutations.Neurology · 2013Pooled it
- Article
- Leber's hereditary optic neuropathy and multiple sclerosis: overlap between mitochondrial disease and neuroinflammation.Frontiers in neurology · 2025Review
- Prolonged-release fampridine for the treatment of myoclonus after cervical myelitis: a case report.Therapeutic advances in neurological disorders · 2022Article
- Fampridine improves acute optic neuritis contributing to a long-lasting recovery of nerve function.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
- Neuroprotective Properties of 4-Aminopyridine.Neurology(R) neuroimmunology & neuroinflammation · 2021Review
- Restoring Axonal Function with 4-Aminopyridine: Clinical Efficacy in Multiple Sclerosis and Beyond.CNS drugs · 2018Review
- Evolution of Visual Outcomes in Clinical Trials for Multiple Sclerosis Disease-Modifying Therapies.Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2018Review
- Assessing treatment outcomes in multiple sclerosis trials and in the clinical setting.Nature reviews. Neurology · 2018Review
- Prolonged-release fampridine in multiple sclerosis: clinical data and real-world experience. Report of an expert meeting.Therapeutic advances in neurological disorders · 2018Review
- [Optical coherence tomography in neuromyelitis optica spectrum disorders].Der Nervenarzt · 2017Review
- Validity of low-contrast letter acuity as a visual performance outcome measure for multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2017Review
- Visual consequences of medications for multiple sclerosis: the good, the bad, the ugly, and the unknown.Eye and brain · 2017Review
- Dalfampridine effects on cognition, fatigue, and dexterity.Brain and behavior · 2017Observational
- Multimodal evoked potentials for functional quantification and prognosis in multiple sclerosis.BMC neurology · 2016Article
- Aquatic training in MS: neurotherapeutic impact upon quality of life.Annals of clinical and translational neurology · 2015Article
- Vision and vision-related outcome measures in multiple sclerosis.Brain : a journal of neurology · 2015Review
- The node of Ranvier in CNS pathology.Acta neuropathologica · 2014Review
- Randomized, Placebo-controlled Crossover Study of Dalfampridine Extended-release in Transverse Myelitis.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objective of this randomized, double-blind, placebo-controlled, crossover study was to examine if patients with optic neuropathy would derive a therapeutic benefit from 4-aminopyridine (4-AP) treatment. Furthermore, the study was intended to determine if patients with certain P100 latencies or retinal nerve fiber layer (RNFL) measures would be more likely to respond to therapy.
methodsPatients were enrolled in a randomized, placebo-controlled, double-blind, crossover study of 10 weeks duration. Patients underwent visual evoked potentials (VEP), optical coherence tomography (OCT), and visual acuity before starting 5 weeks of either placebo or 4-AP. After 5 weeks, they completed a second evaluation (VEP, OCT, and visual acuity) and were crossed over between treatment arms. Five weeks later, they had their final evaluation. All investigators were blinded to treatment arm until after data analysis.
resultsOn average, patients had faster P100s on 4-AP when compared to placebo. A subset of patients had distinct responses to 4-AP as measured by improvements in visual acuity. Finally, eyes with an RNFL measure between 60 and 80 µm had the highest response rate.
conclusions4-Aminopyridine is useful for improving vision in patients with demyelinating optic neuropathy. Future clinical trials may be able to enrich a patient population for potential responders using OCT and VEP measures. Selecting patients for future trials should use RNFL measures as part of inclusion/exclusion criteria. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence supporting the use of 4-AP in certain patients with optic neuropathy to improve visual function (patients with RNFL between 60 and 80 µm).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.