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A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome.

Publication ,  Journal Article
Sanders, DB; Massey, JM; Sanders, LL; Edwards, LJ
Published in: Neurology
February 8, 2000

OBJECTIVES: The authors report the results of a prospective, placebo-controlled, randomized study to evaluate the effectiveness of 3,4-diaminopyridine (DAP) in patients with Lambert-Eaton myasthenic syndrome (LEMS) and to determine the acute and long-term side effects of DAP. METHODS: Twenty-six patients with LEMS completed a two-arm parallel treatment protocol in which DAP, 20 mg three times daily, or placebo was given blindly for 6 days, and a quantitative examination of muscle strength (the quantitative myasthenia gravis [QMG] score) was used as the primary measure of efficacy. After the blinded study, patients were given open-label DAP and monitored for side effects as long as there was symptomatic improvement. RESULTS: Twelve patients took DAP, and 14 took placebo. There was no difference in the age of LEMS onset, gender distribution, incidence of lung cancer, or baseline muscle strength between the patients who were randomly assigned to receive placebo and those randomly assigned to DAP. Statistical analysis using the Wilcoxon's rank sum test demonstrated that patients who received DAP had a significantly greater improvement in the QMG score and in the summated amplitude of compound muscle action potentials recorded from three sentinel limb muscles. All but one LEMS patient had significant symptomatic improvement from subsequent open-label DAP. Side effects of DAP were negligible, consisting of perioral and digital paresthesia. Laboratory measurements demonstrated no evidence of toxicity affecting liver, renal, hematologic, endocrinologic, encephalographic, or electrocardiologic function acutely or after 6 months of open-label DAP. CONCLUSIONS: This study corroborates previous studies and many years of clinical experience showing that DAP is an effective and safe treatment for LEMS.

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Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

February 8, 2000

Volume

54

Issue

3

Start / End Page

603 / 607

Location

United States

Related Subject Headings

  • Prospective Studies
  • Neurology & Neurosurgery
  • Myasthenia Gravis
  • Muscles
  • Middle Aged
  • Male
  • Humans
  • Female
  • Double-Blind Method
  • Amifampridine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sanders, D. B., Massey, J. M., Sanders, L. L., & Edwards, L. J. (2000). A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome. Neurology, 54(3), 603–607. https://doi.org/10.1212/wnl.54.3.603
Sanders, D. B., J. M. Massey, L. L. Sanders, and L. J. Edwards. “A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome.Neurology 54, no. 3 (February 8, 2000): 603–7. https://doi.org/10.1212/wnl.54.3.603.
Sanders DB, Massey JM, Sanders LL, Edwards LJ. A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome. Neurology. 2000 Feb 8;54(3):603–7.
Sanders, D. B., et al. “A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome.Neurology, vol. 54, no. 3, Feb. 2000, pp. 603–07. Pubmed, doi:10.1212/wnl.54.3.603.
Sanders DB, Massey JM, Sanders LL, Edwards LJ. A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome. Neurology. 2000 Feb 8;54(3):603–607.

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

February 8, 2000

Volume

54

Issue

3

Start / End Page

603 / 607

Location

United States

Related Subject Headings

  • Prospective Studies
  • Neurology & Neurosurgery
  • Myasthenia Gravis
  • Muscles
  • Middle Aged
  • Male
  • Humans
  • Female
  • Double-Blind Method
  • Amifampridine