First MS Mobility Drug Gets Green Light From NHS England

NHS England (NHSE) has announced that the first drug designed to improve walking in adults with multiple sclerosis (MS) would now be routinely available on the NHS. Fampridine (Fampyra, Alkermes) acts like a “signal booster” to enhance electrical messages to muscles transmitted by nerves damaged by MS.NHSE said that support for MS-related walking difficulties had largely involved physiotherapy and walking aids, but clinical trials found fampridine improved walking speed in 43% of patients, increased walking speed by around 25%, and also helped people to walk for longer.Two to Four Week Trial NHSE said that eligible patients would initially be able to try fampridine for 2-4 weeks. Those who experienced a clear benefit in walking ability compared with pre-treatment would be allowed to keep taking it, with regular reviews, for as long as it kept working.Announcing the clinical access decision, Professor Frankie Swords, NHS national medical director, said that walking difficulties can have “a huge impact on the freedom and independence of people with MS”, so the treatment “could be life changing for thousands of patients”.Professor James Palmer, national medical director for specialised services at NHSE, added that the treatment offered patients "real hope of greater independence".Thousands of patients would now be able to try fampridine on the NHS, Palmer said, and treatment could continue when it made a clear difference to their mobility and daily lives.The drug is taken as a pill twice a day, and the NHS estimated that around 5000 patients in England would be eligible to take it in the first year.First Licensed Treatment for MS Walking Difficulties Ceri Smith, head of policy and evidence at the MS Society, said the society was "delighted" that fampridine had now been approved for NHS use.For many people the drug is "life-changing", Smith said, "allowing them to live more independently or stay in employment”. "It's vital that MS services now have the support they need to make fampridine available to all people with MS who could benefit from it, regardless of where in England they live," she added.Reverses 2022 NICE Refusal In 2022 the National Institute for Health and Care Excellence (NICE) refused to recommend fampridine on the grounds that it was not a cost-effective treatment at the price offered by the manufacturers, even though it was then available in Scotland and Wales.This year, NHS England’s Clinical Priorities Advisory Group looked at drugs and treatments that were not being assessed by NICE, including those not licensed for the clinical indication in question. It concluded that fampridine should be available as a routine commissioning treatment option for adults with MS and associated walking impairment — as defined by an Expanded Disability Status Scale score of 4-7.The NHSE decision follows the expiry of the patent on the fampridine brand Fampyra, now marketed in the UK by Merz Pharma UK.Fampridine is a potassium channel blocker, which reduces channel leakage of ionic current, thereby prolonging repolarization and enhancing action potential formation in demyelinated axons. This improves neurological function and potentially, by enhancing action potential formation, enables more impulses to be conducted in the central nervous system.About MS and Current Treatment Options MS is a lifelong neurological condition caused by damage to nerves in the brain and spinal cord. Symptoms vary but might include weakness, fatigue, sensory loss, balance and coordination problems, and difficulty walking.NHSE said that support for MS-related walking difficulties had largely involved physiotherapy and exercises, walking aids, devices to support the feet, and treatments to manage muscle stiffness.Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.