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This interventional study provides class 1 evidence that dalfampridine extended-release tablets produce clinically meaningful improvement in walking ability in a subset of people with MS, with the effect maintained between doses.

This phase 2 study suggests that a subgroup of patients, when treated with fampridine, experiences a clinically relevant improvement in walking ability, which is sustained for at least 14 weeks.

Future studies should employ doses up to 20 mg twice daily with lower extremity strength and walking speed as potential outcome measures.

SummaryMesoscopically ordered self-assembled polystyrene, polycarbonate and polymethylmethacrylate films were obtained when polymer solutions were deposited on vertical plates and dried with hot air. It was shown that characteristic size (~ 50 µm) of the mesoscopic cell is practically insensitive to the polymer or substrate kind, while the thickness of the substrate plays a decisive role in the mesoscopic patterning.Junction angles of 120° and 90° were observed. Marangoni instability plays an important role in the cell's structure formation. A semi-quantitative model explaining the phenomenon of mesoscopic cell formation is proposed.

Nature Biotechnology asks selected members of the international community to comment on the ethical issues raised by the prospect of CRISPR-Cas9 engineering of the human germline.

Study design: Two randomized, double-blind, placebo-controlled trials. Objective: To evaluate the efficacy and safety of fampridine sustained-release tablets (fampridine-SR) 25 mg twice daily for moderate-to-severe spasticity in patients with chronic spinal cord injury (SCI). Setting: United States and Canada. Methods: Patients with incomplete chronic SCI were randomized to twice daily fampridine-SR 25 mg or placebo, with a 2-week single-blind placebo run-in, a 2-week titration, 12 weeks of stable dosing, 2 weeks of downward titration and 2 weeks of untreated follow-up. Co-primary end points were the change from baseline, averaged over the double-blind treatment period, for Ashworth score (bilateral knee flexors and extensors) and a 7-point Subject Global Impression of treatment (SGI; 1, terrible; 7, delighted). Secondary end points were: Penn Spasm Frequency Scale; the motor/sensory score from the International Standards for Neurological Classification of SCI; Clinician's Global Impression of Change of neurological status; and the International Index of Erectile Function (men) or the Female Sexual Function Index (women). Results: The populations were 212 and 203 patients in the two studies, respectively. Changes from baseline in Ashworth score were À0.15 (placebo) and À0.19 (fampridine-SR) in the first study, and À0.16 (placebo) and À0.28 (fampridine-SR) in the second study. The between-treatment difference was not significant for either the Ashworth score or the SGI and, with few exceptions, neither were the secondary end points. Fampridine-SR was generally well tolerated; treatment-emergent adverse events (TEAEs) and serious TEAEs were reported with similar frequency between treatments. Conclusion: Fampridine-SR was well tolerated. No significant differences were observed between treatment groups for the primary end points of Ashworth score and SGI.

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