Aminopyridines for symptomatic treatment in multiple sclerosis

Abstract

3,4-diaminopyridine (DAP) and 4-aminopyridine (AP) block potassium channels and can improve action potentials in demyelinated nerve fibres. We identified ten randomised placebo-controlled trials investigating AP/DAP as symptomatic treatment in multiple sclerosis. There is evidence that AP and DAP improve muscle strength in the lower extremities and that AP increases walking speed, and it might improve Expanded Disability Status Scale scores, spasticity and fatigue. There is a lack of evidence-based guidelines of treatment and studies investigating the effect on participation/activity and quality of life.