Page last updated: 2024-12-05

amifampridine

Description Research Excerpts Clinical Trials Roles Classes Pathways Study Profile Bioassays Related Drugs Related Conditions Protein Interactions Research Growth Market Indicators

Description

Amifampridine: 4-Aminopyridine derivative that acts as a POTASSIUM CHANNEL blocker to increase release of ACETYLCHOLINE from nerve terminals. It is used in the treatment of CONGENITAL MYASTHENIC SYNDROMES. [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID5918
CHEMBL ID354077
CHEBI ID135948
SCHEMBL ID21273
MeSH IDM0066295

Synonyms (91)

Synonym
3-amino-4-pyridinylamine
AC-907/34116043
pyridine, 3,4-diamino-
4,5-diaminopyridine
sc10
einecs 200-220-9
nsc 521760
brn 0110232
MLS001304911
smr000752913
STK503647
MLS001333182
MLS001333181
3,4-pyridinediamine
54-96-6
inchi=1/c5h7n3/c6-4-1-2-8-3-5(4)7/h1-3h,7h2,(h2,6,8
pyridine-3,4-diamine
nsc521760
nsc-521760
3,4-diaminopyridine ,
diamino-3,4 pyridine
wln: t6nj cz dz
pyridine,4-diamino-
3,4-dap
3,4 diaminopyridine
D1149
NCGC00167560-01
CHEBI:135948
amifampridine
AKOS000672436
dynamine
3,4-diammoniopyridinium
CHEMBL354077 ,
4-dap
A7976
cas-54-96-6
dtxsid6046715 ,
dtxcid4026715
tox21_112555
amifampridine (usan/inn)
D10228
ruzurgi (tn)
BBL013269
HMS2233K06
S4622
bdbm50416493
amifampridine [usan:inn:ban]
5-22-11-00266 (beilstein handbook reference)
ru4s6e2g0j ,
unii-ru4s6e2g0j
BP-12781
FT-0614203
AM20070030
amifampridine [usan]
ruzurgi
amifampridine [who-dd]
amifampridine [inn]
amifampridine [mi]
amifampridine [orange book]
3,4 diaminopyridine [vandf]
amifampridine [mart.]
amifampridine [ema epar]
CL0116
gtpl8032
HY-14946
SCHEMBL21273
tox21_112555_1
NCGC00167560-02
3,4-diamino-pyridine
3,4-diamino pyridine
J-610017
W-105592
amifampridin
PS-9273
mfcd00006401
F0001-1409
L89 ,
BCP22343
Q411707
DB11640
CCG-304141
54-96-6 (free base)
nsc790505
nsc-790505
PB48915
EN300-69695
amifampridine (mart.)
amifampridina
amifampridinum
n07xx05
Z385438794

Research Excerpts

Effects

ExcerptReferenceRelevance
"Amifampridine has a narrow therapeutic index, and supratherapeutic exposure has been associated with dose-dependent adverse events, including an increased risk for seizure."( Effects of Food Intake on the Relative Bioavailability of Amifampridine Phosphate Salt in Healthy Adults.
Hanson, B; Haroldsen, PE; Musson, DG; O'Neill, CA; Quartel, A, 2015
)
1.38
"Amifampridine has a narrow therapeutic index, and supratherapeutic exposure has been associated with dose-dependent adverse events, including an increased risk for seizure."( Effects of Food Intake on the Relative Bioavailability of Amifampridine Phosphate Salt in Healthy Adults.
Hanson, B; Haroldsen, PE; Musson, DG; O'Neill, CA; Quartel, A, 2015
)
1.38

Treatment

ExcerptReferenceRelevance
"Amifampridine treatment led to a statistically significant improvement in HFMSE (mean difference 0.792; 95% CI from 0.22 to 1.37; p = 0.0083), compared to placebo, but not in secondary outcomes."( Amifampridine safety and efficacy in spinal muscular atrophy ambulatory patients: a randomized, placebo-controlled, crossover phase 2 trial.
Baranello, G; Bonanno, S; Giossi, R; Iannacone, C; Ingenito, G; Iyadurai, S; Maggi, L; Peric, S; Porcelli, V; Stevic, Z; Zanin, R, 2022
)
2.89

Toxicity

SMA-001 study provided Class II evidence that amifampridine was safe and effective in treating ambulatory SMA type 3 patients. The most common adverse events were oral and digital paresthesias, nausea, and headache.

ExcerptReferenceRelevance
"2% of patients presented adverse drug reactions (ADRs) while using moderate doses of 3,4-DAP (20-30 mg daily or up to 80 mg daily for patients with LEMS) for periods of up to 51 months."( 3,4-diaminopyridine safety in clinical practice: an observational, retrospective cohort study.
Allain, H; Edan, G; Flet, L; Guillard, O; Javaudin, L; Leray, E; Polard, E, 2010
)
0.36
" Amifampridine phosphate was well tolerated; the most common adverse events were oral and digital paresthesias, nausea, and headache."( Amifampridine phosphate (Firdapse(®)) is effective and safe in a phase 3 clinical trial in LEMS.
Alsharabati, M; Blanco, JM; Brannagan, T; Dimachkie, M; Komoly, S; Kostera-Pruszczyk, A; Lavrnić, D; Meisel, A; Oh, SJ; Schoser, B; Shcherbakova, N; Shieh, PB; Sivakumar, K; So, Y; Vial, C, 2016
)
2.79
" Safety was evaluated by adverse events (AE) collection."( Amifampridine safety and efficacy in spinal muscular atrophy ambulatory patients: a randomized, placebo-controlled, crossover phase 2 trial.
Baranello, G; Bonanno, S; Giossi, R; Iannacone, C; Ingenito, G; Iyadurai, S; Maggi, L; Peric, S; Porcelli, V; Stevic, Z; Zanin, R, 2022
)
2.16
"SMA-001 study provided Class II evidence that amifampridine was safe and effective in treating ambulatory SMA type 3 patients."( Amifampridine safety and efficacy in spinal muscular atrophy ambulatory patients: a randomized, placebo-controlled, crossover phase 2 trial.
Baranello, G; Bonanno, S; Giossi, R; Iannacone, C; Ingenito, G; Iyadurai, S; Maggi, L; Peric, S; Porcelli, V; Stevic, Z; Zanin, R, 2022
)
2.42

Pharmacokinetics

ExcerptReferenceRelevance
"The purpose of this study is to evaluate safety, tolerability, and pharmacokinetic (PK) properties of amifampridine phosphate (Firdapse™) and its major inactive 3-N-acetyl metabolite in renally impaired and healthy individuals with slow acetylator (SA) and rapid acetylator (RA) phenotypes."( Acetylator Status Impacts Amifampridine Phosphate (Firdapse™) Pharmacokinetics and Exposure to a Greater Extent Than Renal Function.
Datt, J; Haroldsen, PE; Ingenito, G; Musson, DG; Sisic, Z, 2017
)
0.97
" After intravenous administration of 3,4-DAP to rats, the half-life of 3,4-DAP was 15."( Pharmacokinetics and tissue distribution of 3,4-diaminopyridine in rats.
Chikano, Y; Ishida, N; Ishizaki, J; Kobayashi-Nakade, E; Komai, K; Kondo, Y; Matsushita, R; Suga, Y, 2019
)
0.51

Bioavailability

Study assessed the effect of food on the relative bioavailability of amifampridine in healthy subjects and informed on conditions that can alter exposure.

ExcerptReferenceRelevance
" This study assessed the effect of food on the relative bioavailability of amifampridine in healthy subjects and informed on conditions that can alter exposure."( Effects of Food Intake on the Relative Bioavailability of Amifampridine Phosphate Salt in Healthy Adults.
Hanson, B; Haroldsen, PE; Musson, DG; O'Neill, CA; Quartel, A, 2015
)
0.89
" The relative bioavailability values of amifampridine and metabolite were assessed based on the plasma PK parameters AUC0-∞, AUC0-t, and Cmax in the fed and fasted states using noncompartmental pharmacokinetic analysis."( Effects of Food Intake on the Relative Bioavailability of Amifampridine Phosphate Salt in Healthy Adults.
Hanson, B; Haroldsen, PE; Musson, DG; O'Neill, CA; Quartel, A, 2015
)
0.93
"The ATP-binding cassette transporter P-glycoprotein (P-gp) is known to limit both brain penetration and oral bioavailability of many chemotherapy drugs."( A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
Ambudkar, SV; Brimacombe, KR; Chen, L; Gottesman, MM; Guha, R; Hall, MD; Klumpp-Thomas, C; Lee, OW; Lee, TD; Lusvarghi, S; Robey, RW; Shen, M; Tebase, BG, 2019
)
0.51

Dosage Studied

ExcerptRelevanceReference
" The patients were treated with oral 3,4-diaminopyridine, first with increasing single doses up to 100 mg and then with divided dosage for up to 3 weeks."( Preliminary trial of 3,4-diaminopyridine in patients with multiple sclerosis.
Bever, CT; Camenga, DL; Johnson, KP; Leslie, J; Panitch, HS, 1990
)
0.28
" The objective of this study was to evaluate the variability in dosage form weight, active content variability and impurity of compounded oral 3,4-DAP drug products."( Content variability of active drug substance in compounded oral 3,4-diaminopyridine products.
Brain, KR; Green, DM; Jones, AC, 2012
)
0.38
"Variability in dosage form weight ranged from 0·81% relative standard deviation (RSD) to 4·82% RSD."( Content variability of active drug substance in compounded oral 3,4-diaminopyridine products.
Brain, KR; Green, DM; Jones, AC, 2012
)
0.38
" This variability seems to be principally because of heterogeneous formulated material rather than variation in dosage form weight."( Content variability of active drug substance in compounded oral 3,4-diaminopyridine products.
Brain, KR; Green, DM; Jones, AC, 2012
)
0.38
" Amifampridine should be dosed to effect per the individual patient need, altering administration frequency and dose in normal through severe RI."( Acetylator Status Impacts Amifampridine Phosphate (Firdapse™) Pharmacokinetics and Exposure to a Greater Extent Than Renal Function.
Datt, J; Haroldsen, PE; Ingenito, G; Musson, DG; Sisic, Z, 2017
)
1.67
" The daily dosage ranged from 36 to 100 mg."( [A retrospective study of the effects of 3,4-diaminopyridine treatment in Lambert-Eaton myasthenic syndrome].
Kano, T; Matsushima, M; Naganuma, R; Sasaki, H; Takahashi, I; Yabe, I, 2018
)
0.48
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Drug Classes (1)

ClassDescription
aminopyridineCompounds containing a pyridine skeleton substituted by one or more amine groups.
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Protein Targets (13)

Potency Measurements

ProteinTaxonomyMeasurementAverage (µ)Min (ref.)Avg (ref.)Max (ref.)Bioassay(s)
Chain A, Beta-lactamaseEscherichia coli K-12Potency0.70790.044717.8581100.0000AID485294
glp-1 receptor, partialHomo sapiens (human)Potency22.38720.01846.806014.1254AID624417
GLS proteinHomo sapiens (human)Potency15.84890.35487.935539.8107AID624170
estrogen nuclear receptor alphaHomo sapiens (human)Potency2.68060.000229.305416,493.5996AID743075
euchromatic histone-lysine N-methyltransferase 2Homo sapiens (human)Potency1.41250.035520.977089.1251AID504332
aryl hydrocarbon receptorHomo sapiens (human)Potency3.78810.000723.06741,258.9301AID743085; AID743122
parathyroid hormone/parathyroid hormone-related peptide receptor precursorHomo sapiens (human)Potency50.11873.548119.542744.6684AID743266
transcriptional regulator ERG isoform 3Homo sapiens (human)Potency50.11870.794321.275750.1187AID624246
urokinase-type plasminogen activator precursorMus musculus (house mouse)Potency3.16230.15855.287912.5893AID540303
plasminogen precursorMus musculus (house mouse)Potency3.16230.15855.287912.5893AID540303
urokinase plasminogen activator surface receptor precursorMus musculus (house mouse)Potency3.16230.15855.287912.5893AID540303
gemininHomo sapiens (human)Potency0.06120.004611.374133.4983AID624296; AID624297
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Other Measurements

ProteinTaxonomyMeasurementAverageMin (ref.)Avg (ref.)Max (ref.)Bioassay(s)
POU domain, class 2, transcription factor 1Homo sapiens (human)Km508.10002.10005.39008.6000AID1769498
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Biological Processes (4)

Processvia Protein(s)Taxonomy
negative regulation of DNA-templated transcriptionPOU domain, class 2, transcription factor 1Homo sapiens (human)
negative regulation of DNA-templated transcriptionPOU domain, class 2, transcription factor 1Homo sapiens (human)
positive regulation of transcription by RNA polymerase IIPOU domain, class 2, transcription factor 1Homo sapiens (human)
positive regulation of miRNA transcriptionPOU domain, class 2, transcription factor 1Homo sapiens (human)
regulation of transcription by RNA polymerase IIPOU domain, class 2, transcription factor 1Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Molecular Functions (7)

Processvia Protein(s)Taxonomy
RNA polymerase II cis-regulatory region sequence-specific DNA bindingPOU domain, class 2, transcription factor 1Homo sapiens (human)
RNA polymerase II core promoter sequence-specific DNA bindingPOU domain, class 2, transcription factor 1Homo sapiens (human)
DNA-binding transcription factor activity, RNA polymerase II-specificPOU domain, class 2, transcription factor 1Homo sapiens (human)
DNA-binding transcription activator activity, RNA polymerase II-specificPOU domain, class 2, transcription factor 1Homo sapiens (human)
DNA bindingPOU domain, class 2, transcription factor 1Homo sapiens (human)
protein bindingPOU domain, class 2, transcription factor 1Homo sapiens (human)
sequence-specific DNA bindingPOU domain, class 2, transcription factor 1Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Ceullar Components (6)

Processvia Protein(s)Taxonomy
nucleusPOU domain, class 2, transcription factor 1Homo sapiens (human)
nucleoplasmPOU domain, class 2, transcription factor 1Homo sapiens (human)
endoplasmic reticulumPOU domain, class 2, transcription factor 1Homo sapiens (human)
intracellular membrane-bounded organellePOU domain, class 2, transcription factor 1Homo sapiens (human)
chromatinPOU domain, class 2, transcription factor 1Homo sapiens (human)
RNA polymerase II transcription regulator complexPOU domain, class 2, transcription factor 1Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Bioassays (50)

Assay IDTitleYearJournalArticle
AID1347108qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh41 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347094qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for BT-37 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347092qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for A673 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347096qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for U-2 OS cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347107qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh30 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347101qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for BT-12 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347097qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Saos-2 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347083qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lassa (LASV) Arenavirus: Viability assay - alamar blue signal for LASV Primary Screen2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347093qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SK-N-MC cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347407qHTS to identify inhibitors of the type 1 interferon - major histocompatibility complex class I in skeletal muscle: primary screen against the NCATS Pharmaceutical Collection2020ACS chemical biology, 07-17, Volume: 15, Issue:7
High-Throughput Screening to Identify Inhibitors of the Type I Interferon-Major Histocompatibility Complex Class I Pathway in Skeletal Muscle.
AID1347091qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SJ-GBM2 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347095qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for NB-EBc1 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347090qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for DAOY cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347105qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for MG 63 (6-TG R) cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347099qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for NB1643 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1296008Cytotoxic Profiling of Annotated Libraries Using Quantitative High-Throughput Screening2020SLAS discovery : advancing life sciences R & D, 01, Volume: 25, Issue:1
Cytotoxic Profiling of Annotated and Diverse Chemical Libraries Using Quantitative High-Throughput Screening.
AID1347106qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for control Hh wild type fibroblast cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347425Rhodamine-PBP qHTS Assay for Modulators of WT P53-Induced Phosphatase 1 (WIP1)2019The Journal of biological chemistry, 11-15, Volume: 294, Issue:46
Physiologically relevant orthogonal assays for the discovery of small-molecule modulators of WIP1 phosphatase in high-throughput screens.
AID1745845Primary qHTS for Inhibitors of ATXN expression
AID1347082qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lassa (LASV) Arenavirus: LASV Primary Screen - GLuc reporter signal2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347089qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for TC32 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347102qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh18 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347104qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for RD cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347098qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SK-N-SH cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1508630Primary qHTS for small molecule stabilizers of the endoplasmic reticulum resident proteome: Secreted ER Calcium Modulated Protein (SERCaMP) assay2021Cell reports, 04-27, Volume: 35, Issue:4
A target-agnostic screen identifies approved drugs to stabilize the endoplasmic reticulum-resident proteome.
AID1347424RapidFire Mass Spectrometry qHTS Assay for Modulators of WT P53-Induced Phosphatase 1 (WIP1)2019The Journal of biological chemistry, 11-15, Volume: 294, Issue:46
Physiologically relevant orthogonal assays for the discovery of small-molecule modulators of WIP1 phosphatase in high-throughput screens.
AID651635Viability Counterscreen for Primary qHTS for Inhibitors of ATXN expression
AID1347103qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for OHS-50 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347154Primary screen GU AMC qHTS for Zika virus inhibitors2020Proceedings of the National Academy of Sciences of the United States of America, 12-08, Volume: 117, Issue:49
Therapeutic candidates for the Zika virus identified by a high-throughput screen for Zika protease inhibitors.
AID1347100qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for LAN-5 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347086qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lymphocytic Choriomeningitis Arenaviruses (LCMV): LCMV Primary Screen - GLuc reporter signal2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1346987P-glycoprotein substrates identified in KB-8-5-11 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1346986P-glycoprotein substrates identified in KB-3-1 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID504810Antagonists of the Thyroid Stimulating Hormone Receptor: HTS campaign2010Endocrinology, Jul, Volume: 151, Issue:7
A small molecule inverse agonist for the human thyroid-stimulating hormone receptor.
AID504812Inverse Agonists of the Thyroid Stimulating Hormone Receptor: HTS campaign2010Endocrinology, Jul, Volume: 151, Issue:7
A small molecule inverse agonist for the human thyroid-stimulating hormone receptor.
AID1769501Ratio of drug uptake in human OCT1 expressing HEK293 cells at 2.5 uM to drug uptake in empty vector transfected human HEK293 cells at 2.5 uM2021Journal of medicinal chemistry, 03-11, Volume: 64, Issue:5
Identification of Novel High-Affinity Substrates of OCT1 Using Machine Learning-Guided Virtual Screening and Experimental Validation.
AID1769498Substrate activity at human OCT1 expressed in HEK293 cells assessed as increase in compound uptake by measuring Km incubated for 2 mins by LC-MS/MS analysis2021Journal of medicinal chemistry, 03-11, Volume: 64, Issue:5
Identification of Novel High-Affinity Substrates of OCT1 Using Machine Learning-Guided Virtual Screening and Experimental Validation.
AID494749Inhibition of [3H]choline uptake at choline transporter 1 in mouse brain synaptosome2010Bioorganic & medicinal chemistry letters, Aug-15, Volume: 20, Issue:16
3-D-QSAR and docking studies on the neuronal choline transporter.
AID1769500Substrate activity at human OCT1 expressed in HEK293 cells assessed as increase in compound uptake by measuring intrinsic clearance incubated for 2 mins by LC-MS/MS analysis2021Journal of medicinal chemistry, 03-11, Volume: 64, Issue:5
Identification of Novel High-Affinity Substrates of OCT1 Using Machine Learning-Guided Virtual Screening and Experimental Validation.
AID1769499Substrate activity at human OCT1 expressed in HEK293 cells assessed as increase in compound uptake by measuring Vmax incubated for 2 mins by LC-MS/MS analysis2021Journal of medicinal chemistry, 03-11, Volume: 64, Issue:5
Identification of Novel High-Affinity Substrates of OCT1 Using Machine Learning-Guided Virtual Screening and Experimental Validation.
AID588499High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain A protease, MLPCN compound set2010Current protocols in cytometry, Oct, Volume: Chapter 13Microsphere-based flow cytometry protease assays for use in protease activity detection and high-throughput screening.
AID588499High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain A protease, MLPCN compound set2006Cytometry. Part A : the journal of the International Society for Analytical Cytology, May, Volume: 69, Issue:5
Microsphere-based protease assays and screening application for lethal factor and factor Xa.
AID588499High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain A protease, MLPCN compound set2010Assay and drug development technologies, Feb, Volume: 8, Issue:1
High-throughput multiplex flow cytometry screening for botulinum neurotoxin type a light chain protease inhibitors.
AID588497High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain F protease, MLPCN compound set2010Current protocols in cytometry, Oct, Volume: Chapter 13Microsphere-based flow cytometry protease assays for use in protease activity detection and high-throughput screening.
AID588497High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain F protease, MLPCN compound set2006Cytometry. Part A : the journal of the International Society for Analytical Cytology, May, Volume: 69, Issue:5
Microsphere-based protease assays and screening application for lethal factor and factor Xa.
AID588497High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain F protease, MLPCN compound set2010Assay and drug development technologies, Feb, Volume: 8, Issue:1
High-throughput multiplex flow cytometry screening for botulinum neurotoxin type a light chain protease inhibitors.
AID588501High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Lethal Factor Protease, MLPCN compound set2010Current protocols in cytometry, Oct, Volume: Chapter 13Microsphere-based flow cytometry protease assays for use in protease activity detection and high-throughput screening.
AID588501High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Lethal Factor Protease, MLPCN compound set2006Cytometry. Part A : the journal of the International Society for Analytical Cytology, May, Volume: 69, Issue:5
Microsphere-based protease assays and screening application for lethal factor and factor Xa.
AID588501High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Lethal Factor Protease, MLPCN compound set2010Assay and drug development technologies, Feb, Volume: 8, Issue:1
High-throughput multiplex flow cytometry screening for botulinum neurotoxin type a light chain protease inhibitors.
AID504749qHTS profiling for inhibitors of Plasmodium falciparum proliferation2011Science (New York, N.Y.), Aug-05, Volume: 333, Issue:6043
Chemical genomic profiling for antimalarial therapies, response signatures, and molecular targets.
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (388)

TimeframeStudies, This Drug (%)All Drugs %
pre-1990101 (26.03)18.7374
1990's120 (30.93)18.2507
2000's63 (16.24)29.6817
2010's82 (21.13)24.3611
2020's22 (5.67)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 56.07

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be very strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index56.07 (24.57)
Research Supply Index6.07 (2.92)
Research Growth Index4.53 (4.65)
Search Engine Demand Index93.49 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (56.07)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials31 (7.75%)5.53%
Reviews32 (8.00%)6.00%
Case Studies45 (11.25%)4.05%
Observational0 (0.00%)0.25%
Other292 (73.00%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (25)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Treatment of Lambert-Eaton Myasthenic Syndrome and Congenital Myasthenic Syndromes With 3, 4-Diaminopyridine [NCT01378546]0 participants Expanded Access2005-05-31No longer available
Use Of 3,4-Diaminopyridine (3,4-DAP) In The Treatment Of Lambert Eaton Myasthenic Syndrome [NCT01373333]0 participants Expanded Access1997-09-30No longer available
Long Term Safety Study of Amifampridine Phosphate in Patients With MuSK Antibody Positive and AChR (Acetylcholine Receptor) Antibody Positive Myasthenia Gravis [NCT03579966]Phase 370 participants (Anticipated)Interventional2018-07-01Active, not recruiting
A Phase 3, Double-blind, Placebo-controlled, Randomized Discontinuation Study Followed by Open-label Extension Evaluating Efficacy and Safety of Amifampridine Phosphate in Patients With Lambert-Eaton Myasthenic Syndrome (LEMS) [NCT01377922]Phase 338 participants (Actual)Interventional2011-06-30Completed
Open Label Trial Of 3,4-Diaminopyridine In Lambert-Eaton Myasthenic Syndrome (LEMS) and Congenital Myasthenic Syndromes (CMS) [NCT00872950]0 participants Expanded AccessApproved for marketing
Treatment Use of 3,4-Diaminopyridine in Congenital Myasthenic Syndrome [NCT01765140]0 participants Expanded AccessNo longer available
Amifampridine for the Treatment of Transient Vocal Weakness After OnabotulinumtoxinA Injection for Spasmodic Dysphonia [NCT05123053]Phase 210 participants (Anticipated)Interventional2021-10-28Recruiting
Treatment of Lambert-Eaton Syndrome With 3, 4-Diaminopyridine [NCT00704925]0 participants Expanded AccessNo longer available
IMproving Symptomatic Treatment With Pyridostigmine and Amifampridine: a Randomized Double-blinded, Placebo Controlled Crossover Trial in Patients With Myasthenia Gravis (IMPACT-MG) [NCT05919407]Phase 324 participants (Anticipated)Interventional2023-03-22Recruiting
Treatment of Lambert-Eaton Syndrome With 3,4 Diaminopyridine [NCT00994916]0 participants Expanded AccessNo longer available
3,4-Diaminopyridine for Lambert-Eaton Myasthenic Syndrome and Congenital Myasthenia [NCT02012933]0 participants Expanded AccessNo longer available
Multicentric Study, Comparative, Randomized, in Double Knowledge of the Effectiveness (Versus Placebo) of a Salt Of 3,4 - Diaminopyridine in the Treatment of Tiredness During the Multiple Sclerosis [NCT00190268]Phase 3126 participants (Actual)Interventional2005-02-28Completed
A Phase 3, Double-Blind, Placebo-controlled, Randomized, Parallel-Group Study to Evaluate the Efficacy and Safety of Amifampridine Phosphate in Patients With Lambert-Eaton Myasthenic Syndrome [NCT02970162]Phase 326 participants (Actual)Interventional2016-11-30Completed
A Proof of Concept Study of the Effect of Amifampridine (Firdapse®) on Neuromuscular Transmission in Patients Treated With OnabotulinumtoxinA (Botox®, BTX-A) [NCT05769478]Phase 120 participants (Anticipated)Interventional2023-09-15Recruiting
A Phase 3, Double-blind, Outpatient Crossover Study to Evaluate the Efficacy and Safety of Amifampridine Phosphate (3,4 Diaminopyridine Phosphate) in Patients With Congenital Myasthenic Syndromes (CMS) [NCT02562066]Phase 320 participants (Actual)Interventional2016-01-31Completed
Fatigue in Multiple Sclerosis: Evaluated With 3 Tesla MRI and Transcranial Magnetic Stimulation [NCT00342381]Phase 2120 participants (Anticipated)Interventional2006-06-30Completed
Use of 3,4-Diaminopyridine(3 4-DAP)in the Treatment of Lambert-Eaton Syndrome (LEMS) [NCT01825395]0 participants Expanded AccessApproved for marketing
Inpatient Double-Blind Placebo-Controlled Withdrawal Study of 3,4-Diaminopyridine Base (3,4-DAP) in Subjects With Known Lambert-Eaton Myasthenic Syndrome [NCT01511978]Phase 232 participants (Actual)Interventional2012-01-31Completed
A Randomized, Placebo-Controlled, Crossover Study to Evaluate the Safety and Efficacy of Amifampridine Phosphate in Ambulatory Patients With Spinal Muscular Atrophy (SMA) Type 3 [NCT03781479]Phase 213 participants (Actual)Interventional2019-01-21Completed
Pilot Study on the Usefulness of 3,4-diaminopyridine in the Treatment of Botulism [NCT01441557]Phase 2/Phase 33 participants (Actual)Interventional2011-09-30Completed
A Randomized, Placebo-control, Parallel Group Study to Evaluate the Effect of Amifampridine Phosphate in Patients With MuSK Antibody Positive Myasthenia Gravis, and a Sample of AChR Antibody Positive Myasthenia Gravis Patients [NCT03304054]Phase 393 participants (Actual)Interventional2018-04-18Completed
Long Term Safety Study of Amifampridine Phosphate in Ambulatory Patients With Spinal Muscular Atrophy (SMA) Type 3 [NCT03819660]Phase 213 participants (Actual)Interventional2019-03-07Terminated(stopped due to Development of indication not being pursued)
[NCT00004832]26 participants Interventional1994-08-31Completed
An Open-Label, Expanded Access Protocol for Firdapse® (Amifampridine Phosphate; 3,4-Diaminopyridine Phosphate) Treatment in Pediatric Patients With Lambert-Eaton Myasthenic Syndrome (LEMS), and in Pediatric and Adult Patients With Congenital Myasthenic Sy [NCT02189720]0 participants Expanded AccessNo longer available
Treatment Use of 3,4 Diaminopyridine in Congenital Myasthenia [NCT03062631]0 participants Expanded AccessNo longer available
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT01377922 (4) [back to overview]Change From Baseline Quantitative Myasthenia Gravis (QMG) at 14 Days
NCT01377922 (4) [back to overview]Change From Baseline Timed 25 Foot Walking Test (T25FW) at 14 Days
NCT01377922 (4) [back to overview]Change in CGI-I Score
NCT01377922 (4) [back to overview]Change in SGI Score
NCT01511978 (2) [back to overview]Number of Participants With 30% or More Deterioration in Triple Timed Up & Go (3TUG) Test, Compared to Time-matched Baseline
NCT01511978 (2) [back to overview]Self-assessment of LEMS-related Weakness, W-SAS
NCT02562066 (3) [back to overview]Motor Function Measure 20 (MFM-20) Score Mixed Model Analysis, MFM-20 Score Mixed Model Analysis
NCT02562066 (3) [back to overview]Motor Function Measure 32 (MFM-32) Score Summary: Mann-Whitney Main Effect Test Results, MFM-32 Score Mixed Model Analysis
NCT02562066 (3) [back to overview]Subject Global Impression (SGI) Score Summary: Mann-Whitney Main Effects Test Results; SGI Score Mixed Model Analysis
NCT02970162 (4) [back to overview]Change in Clinician's Global Impression of Improvement (CGI-I) at Day 4 Compared to Baseline
NCT02970162 (4) [back to overview]Triple Timed Up and Go Walk Test (3TUG)
NCT02970162 (4) [back to overview]Quantitative Myasthenia Gravis (QMG) Score
NCT02970162 (4) [back to overview]Subject Global Impression (SGI) Score
NCT03304054 (2) [back to overview]Myasthenia Gravis-Activities of Daily Living (MG-ADL) Summary by Time Point and Myasthenia Gravis Type: Wilcoxon-Mann-Whitney Rank Sum Test Results
NCT03304054 (2) [back to overview]Quantitative Myasthenia Gravis (QMG) Total Score Summary Statistics by Time Point and MG Type: Wilcoxon-Mann-Whitney Rank Sum Test Results
NCT03781479 (1) [back to overview]Hammersmith Functional Motor Scale Expanded (HFMSE) Summary Statistics and Mixed Model Analysis
NCT03819660 (2) [back to overview]Long-term Safety and Tolerability of Amifampridine
NCT03819660 (2) [back to overview]To Assess the Clinical Efficacy of Amifampridine Phosphate Over Time in Patients With SMA Type 3 Based on Changes in Quality of Life (QoL).

Change From Baseline Quantitative Myasthenia Gravis (QMG) at 14 Days

The QMG is a physician-rated test including 13 assessments, including facial strength, swallowing, grip strength, and duration of time that limbs can be maintained in outstretched positions. Each of the 13 items is scored from 0 (none) to 3 (severe). The total score can range from 0 to 39. Increased QMG total score correlates to worsening symptoms of LEMS. (NCT01377922)
Timeframe: Assessment at Baseline and Day 14

,
InterventionQMG Score (Mean)
BaselineDay 14Change from Baseline
Amifampridine Phosphate6.46.70.3
Placebo5.67.92.2

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Change From Baseline Timed 25 Foot Walking Test (T25FW) at 14 Days

"The T25FW test, a component of the Multiple Sclerosis Functional Composite, was a quantitative mobility and leg function performance test based on a timed 25-foot walk (National Multiple Sclerosis Society). The patient was directed to walk a clearly marked 25-foot course as quickly and safely as possible. Following a rest of at least 5 minutes, the timed 25-foot walk was repeated. Patients could use assistive devices, such as canes, crutches, or walkers.~All data were normalized to the number of feet per minute, so if the patient walked 25 feet in less than a minute, the result was a speed greater than 25 feet/minute.~The measurement for the T25FW test was the average speed, expressed in feet/minute, of the 2 completed walks." (NCT01377922)
Timeframe: Assessment at Baseline and Day 14

,
Interventionfeet/minute (Mean)
BaselineDay 14Change from Baseline
Amifampridine Phosphate254253-1.46
Placebo255244-10.4

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Change in CGI-I Score

"The Investigator completed the 7-point CGI I, based on changes in symptoms, behavior, and functional abilities, at the protocol-specified time points compared to the patient's condition at Day 0.~= Very much improved~= Much improved~= Minimally improved~= No change~= Minimally worse~= Much worse~= Very much worse" (NCT01377922)
Timeframe: Baseline and Day 14

,
InterventionCGI-I score (Mean)
BaselineDay 14
Amifampridine Phosphate2.63.6
Placebo2.54.8

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Change in SGI Score

"Subject Global Impression (SGI) is a measure of changes in subject's perception of change in overall wellbeing.~The patient is asked to use the 7-point scale below to rate their impression of the effects of the study medication during the preceding 3 days on their physical well being.~Terrible~Mostly dissatisfied~Mixed~Partially satisfied~Mostly satisfied~Pleased~Delighted" (NCT01377922)
Timeframe: Assessment at Baseline and Day 14

,
InterventionSGI score (Mean)
BaselineDay 14Change from Baseline
Amifampridine Phosphate5.64.9-0.7
Placebo5.93.2-2.7

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Number of Participants With 30% or More Deterioration in Triple Timed Up & Go (3TUG) Test, Compared to Time-matched Baseline

"The 3TUG time obtained 2 hours after the last dose of the withdrawal period (i.e., at time of theoretical peak drug effect) was compared to the average time-matched 3TUG tests performed during 2 days of baseline observation prior to randomization.~The study endpoint was a change of more than 30% in the final post-dose 3TUG during the withdrawal period and was based on blinded readings of video recordings of 3TUG tests." (NCT01511978)
Timeframe: Baseline period (days 0, 1, 2); Randomized treatment period (starting with last dose of day 2, and days 3, 4, 5, and ending with first dose on day 6 when pre-randomization regimen was resumed, or rescue, if indicated sooner)

InterventionParticipants (Count of Participants)
Continuous 3,4-Diaminopyridine (3,4-DAP)0
3,4-DAP Taper to Placebo13

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Motor Function Measure 20 (MFM-20) Score Mixed Model Analysis, MFM-20 Score Mixed Model Analysis

Motor Function Measure 20 (MFM-20) evaluates the severity and progression of motor function in patients 2 to 6 years of age with max total score = 60 (best score) and min total score =0 (worst score). It will be completed at D0 (baseline for Study Period 1), D8, D21 (baseline for Study Period 2) and D29. CFB will be assessed for Study Period 1 (difference in MFM-20 from D0 to D8), Study Period 2 (difference in MFM-20 from D21 to D28) and the change in CFB from Study Period 1 to Study Period 2 (difference between CFB during Study Period 1 and CFB during Study Period 2). A Mann-Whitney-Wilcoxon test for equality of CFB results in the two treatments in Period 1 and for the equality of the CFB results in the two treatment sequences will be conducted. A mixed effects linear model will be fit to the overall MFM-32 score as the response variable and fixed effect terms for treatment, period, age group, genetic mutation type, and sequence*period and a random effect for patient. (NCT02562066)
Timeframe: Study Period 1: Baseline (Day 0), Day 8; Study Period 2: Baseline (Day 21), Day 29

,
InterventionScore on a Scale (Mean)
Study Period 1: CFB in Overall MFM-20 Score at Day 8Study Period 2: CFB in Overall MFM-20 Score at Day 29
Amifampridine Phosphate - Placebo-1.50-0.75
Placebo - Amifampridine Phosphate-0.501.50

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Motor Function Measure 32 (MFM-32) Score Summary: Mann-Whitney Main Effect Test Results, MFM-32 Score Mixed Model Analysis

Motor Function Measure 32 (MFM-32) evaluates the severity and progression of motor function in patients 7 years of age or older with max total score = 96 (best score) and min total score =0 (worst score). It will be completed at D0 (baseline for Study Period 1), D8, D21 (baseline for Study Period 2) and D29. CFB will be assessed for Study Period 1 (difference in MFM-32 from D0 to D8), Study Period 2 (difference in MFM-32 from D21 to D28) and the change in CFB from Study Period 1 to Study Period 2 (difference between CFB during Study Period 1 and CFB during Study Period 2). A Mann-Whitney-Wilcoxon test for equality of CFB results in the two treatments in Period 1 and for the equality of the CFB results in the two treatment sequences will be conducted. A mixed effects linear model will be fit to the overall MFM-32 score as the response variable and fixed effect terms for treatment, period, age group, genetic mutation type, and sequence*period and a random effect for patient. (NCT02562066)
Timeframe: Study Period 1: Baseline (Day 0), Day 8; Study Period 2: Baseline (Day 21), Day 29

,
InterventionScore on a Scale (Mean)
Study Period 1: CFB in Overall MFM-32 Score at Day 8Study Period 2: CFB in Overall MFM-32 Score at Day 29
Amifampridine Phosphate - Placebo3.000.75
Placebo - Amifampridine Phosphate-0.17-0.60

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Subject Global Impression (SGI) Score Summary: Mann-Whitney Main Effects Test Results; SGI Score Mixed Model Analysis

Subject Global Impression (SGI) rates the subject's impression of the effects of the study medication during the preceding week with max score =7 (most satisfied) and min score =1 (least satisfied). It will be completed at D0 (baseline for Study Period 1), D8, D21 (baseline for Study Period 2), and D29. Change from baseline (CFB) will be assessed for Study Period 1 (difference in SGI score from D0 to D8), Study Period 2 (difference in SGI score from D21 to D29) and the change in CFB from Study Period 1 to Study Period 2 (difference between CFB during Study Period 1 and CFB during Study Period 2). A Mann-Whitney-Wilcoxon test for equality of the CFB results in the two treatments in Period 1 and for the equality of the CFB results in the two treatment sequences will be conducted. A mixed effects liner model will be fit with the SGI raw scores as a response and study arm, treatment, period, age group and mutation type as fixed effect terms and patient as a random effect. (NCT02562066)
Timeframe: Study Period 1: Baseline (Day 0), Day 8; Study Period 2: Baseline (Day 21), Day 29

,
InterventionScores on a scale (Mean)
Study Period 1: CFB in SGI Score at Day 8Study Period 2 : CFB in SGI Score at Day 29
Amifampridine Phosphate - Placebo-0.13-0.75
Placebo - Amifampridine Phosphate-1.75-1.14

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Change in Clinician's Global Impression of Improvement (CGI-I) at Day 4 Compared to Baseline

The CGI-I captures the Investigator's global impression of the patient's improvement or worsening from baseline status. The 7-point scale is scored by the Investigator based on changes in symptoms, behavior, and functional abilities. Each symptom is rated as 1 (very much improved), 2 (much improved), 3 (minimally improved), 4 (no change), 5 (minimally worse), 6 (much worse), or 7 (very much worse). The total score can range from 0 to 49. A higher score indicates a worse outcome. (NCT02970162)
Timeframe: change from baseline in CGI-I score at end of day 4

Interventionscores on a scale (Mean)
Amifampridine Phosphate3.8
Placebo (for Amifampridine Phosphate)5.5

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Triple Timed Up and Go Walk Test (3TUG)

The 3TUG is a functional mobility test that requires a patient to stand up from a straight-backed armchair, walk 3 meters, turn around, walk back, and sit down in the chair. A modification of this is where the individual performs the test 3 times without pause, and the measurement is the average time required to complete each of the 3 repetitions. Based upon literature reports that a significant change in gait for a similar walk-test is an increase in time of more than 20%, this has been incorporated into the endpoint. (NCT02970162)
Timeframe: change from baseline in 3TUG at end of day 4

InterventionParticipants (Count of Participants)
Amifampridine Phosphate1
Placebo (for Amifampridine Phosphate)8

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Quantitative Myasthenia Gravis (QMG) Score

The QMG is a physician-rated test including 13 assessments such as facial strength, swallowing, grip strength, and duration of time that limbs can be maintained in outstretched positions. Each assessment is graded as 0 (none), 1 (mild), 2 (moderate), or 3 (severe), for a total range of 0-39. A higher total score indicates a worse outcome. (NCT02970162)
Timeframe: change from baseline in QMG score at end of day 4

,
Interventionscores on a scale (Mean)
BaselineDay 4Change from baseline
Amifampridine Phosphate7.87.90.1
Placebo (for Amifampridine Phosphate)8.515.06.5

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Subject Global Impression (SGI) Score

The SGI is a 7-point scale on which the patient rates their global impression of the effects of a study treatment (1=terrible to 7=delighted). The SGI was assessed by the patient or the patient's parent/guardian/caregiver if the patient was unable to complete the SGI. The SGI has demonstrated concordance with the physician's assessment of improvement. (NCT02970162)
Timeframe: change from baseline in SGI score at end of day 4

,
Interventionscores on a scale (Mean)
BaselineDay 4Change from baseline to Day 4
Amifampridine Phosphate6.15.3-0.8
Placebo (for Amifampridine Phosphate)5.82.4-3.5

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Myasthenia Gravis-Activities of Daily Living (MG-ADL) Summary by Time Point and Myasthenia Gravis Type: Wilcoxon-Mann-Whitney Rank Sum Test Results

Myasthenia Gravis-Activities of Daily Living (MG-ADL) is a self-report scale to assess the patient's MG symptoms and functional performance of activities of daily living. The eight items are scored on a scale of 0-3 with 3 representing the most severe symptoms or impaired performance and 0 representing no symptoms or impaired performance. Each item was assessed by the patient at the last day (Day 0) of the Run-in period and at the post-treatment visit. The post-treatment result will be the result obtained on Day 10. If the patient discontinued treatment early, the post-treatment result may be obtained at an earlier time point. The total MG-ADL score was calculated as the sum of each item score, with a maximum score of 24 (most severe symptoms/impairment) and minimum score of 0 (least severe symptoms/impairment). The change from baseline (CFB) at Day 10 was assessed. A Wilcoxon-Mann-Whitney Rank Sum Test of equality of change from baseline distributions between subjects diagnos (NCT03304054)
Timeframe: Last day (Day 0) of the Run-in period and at the post-treatment visit (i.e., day 10 or the time point at which a patient discontinued treatment early).

,,,
InterventionScore on a Scale (Mean)
Baseline (Day 0) MG-ADL Total Raw ScorePost-Baseline(Day 10 or time at which a patient discontinued treatment) MG-ADL Total Raw ScoreCFB MG-ADL Total Score
Amifampridine Phosphate - AChR6.144.71-1.43
Amifampridine Phosphate - MuSK4.966.001.04
Placebo - AChR7.0010.383.38
Placebo - MuSK3.866.112.25

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Quantitative Myasthenia Gravis (QMG) Total Score Summary Statistics by Time Point and MG Type: Wilcoxon-Mann-Whitney Rank Sum Test Results

Quantitative Myasthenia Gravis (QMG) assesses the patient's general body strength and fatigability. Each test item is scored on a scale of 0-3 with 3 representing the most severe symptom results and 0 representing no symptom results. Each item was assessed by the patient at Screening, the first (Day 1) and last day (Day 0) of the Run-in period and at the post-treatment visit. The post-treatment result will be the result obtained on Day 10. If the patient discontinued treatment early, the post-treatment result may be obtained at an earlier time point. The total QMG score was calculated as the sum of each item score, with a maximum score of 39 (most severe symptoms) and minimum score of 0 (least severe symptoms). The change from baseline (CFB) at Day 10 was assessed. A Wilcoxon-Mann-Whitney Rank Sum Test of equality of change from baseline distributions between subjects diagnosed with MuSK-MG treated with amifampridine and placebo was conducted. (NCT03304054)
Timeframe: Last day (Day 0) of the Run-in period and at the post-treatment visit (i.e., day 10 or the time at which a patient discontinued treatment early).

,,,
InterventionScore on a Scale (Mean)
Baseline (Day 0) QMG Total Raw ScorePost-Baseline (day 10 or time at which a patient discontinued treatment early) QMG Total Raw ScoreCFB QMG Total Score
Amifampridine Phosphate - AChR10.5710.860.29
Amifampridine Phosphate - MuSK10.0011.191.19
Placebo - AChR14.1314.430.86
Placebo - MuSK8.6410.161.80

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Hammersmith Functional Motor Scale Expanded (HFMSE) Summary Statistics and Mixed Model Analysis

Hammersmith Functional Motor Scale Expanded (HFMSE) assesses motor function by functional item in order of progressive difficulty, with higher values showing higher function abilities. Each item is scored on a scale of 0-2 with 2 representing item achieved unaided and 0 representing inability to achieve item. Each item was assessed by the patient at Screening, the first (Day 1) and last day (Day 0) of the Run-in period, during Period 1 at Day 7 and Day 14, and during Period 2 at Day 21 and Day 28. The total HFMSE score was calculated as the sum of each item score, with a maximum score of 66 (all items achieved unaided) and minimum score of 0 (all items failed). Change from baseline (CFB) will be assessed from Day 0 to Day 28. A mixed effects liner model was fit with the HFMSE change from baseline (CFB) scores at Day 28 as a response and treatment, sequence, and treatment by sequence as fixed effect terms and patient as a random effect. (NCT03781479)
Timeframe: Screening, the first (Day 1) and last day (Day 0) of the Run-in period, during Period 1 at Day 7 and Day 14, and during Period 2 at Day 21 and Day 28

InterventionOverall Score (Least Squares Mean)
Amifampridine Phosphate0.208
Placebo-0.583

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Long-term Safety and Tolerability of Amifampridine

Number of subjects with treatment emergent adverse events (TEAE). (NCT03819660)
Timeframe: 18 months

InterventionParticipants (Count of Participants)
Amifampridine Phosphate5

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To Assess the Clinical Efficacy of Amifampridine Phosphate Over Time in Patients With SMA Type 3 Based on Changes in Quality of Life (QoL).

"Quality of life (QoL): the Individualized Quality of Life for neuromuscular disease (INQoL) or the Pediatric Quality of Life (PEDSQLTM) was used for adult or pediatric patients, respectively. Since there were no pediatric patients, none of the patients completed the PEDSQL.~The INQol evaluated weakness, pain, fatigue, double vision, muscle locking, droopy eyelids, swallowing difficulties, activities, social relationships, emotions and body image. Each of these areas were measured in four categories as follows: 1- Incidence (0= No, 1 =Yes), 2-Severity (0= None to 7 = extreme), 3- Impact - (0= None to 6 = extreme) and 4-Importance (0= None to 6 = extreme). The numbers were summative and are input to the QOL calculation, which is a percentage of severity on a scale of 0-100. The mean value was taken across this population. The higher scores were a worse outcome." (NCT03819660)
Timeframe: Screening to end of study.

Interventionscore on a scale (Mean)
screeningEnd of Study
Amifampridine Phosphate33.73739.012

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