Therapeutic efficacy and adverse effects of adrenocorticotropic hormone therapy in west syndrome: differences in dosage of adrenocorticotropic hormone, onset of age, and cause

The Journal of Pediatrics
Shin-ichiro HamanoYoshikatsu Eto

Abstract

To determine the dosage and factors influencing efficacy of adrenocorticotropic hormone (ACTH) for West syndrome. A retrospective study of 135 patients receiving ACTH therapy with a synthetic analogue for initial effect, seizure outcome 1 year after therapy, and adverse effects. Efficacy and adverse effects were compared among the groups divided by clinical factors: dosage, treatment lag, onset age, and cause. One hundred thirteen patients had seizure control with ACTH. For more than 1 year after ACTH, 59 remained seizure free. Adverse effects were observed in 57, and ACTH therapy was discontinued in 23. The lowest dosage group (0.0125 mg/kg/d) had fewer episodes of discontinuation (P<.05), whereas differences in efficacy between different dosages were insignificant. None of the clinical factors correlated with initial effect. The earlier-onset group (<4 months) showed unfavorable seizure outcome 1 year after ACTH (P<.01). The cryptogenic patients showed better seizure outcome (P<.05) compared with the symptomatic. Synthetic ACTH therapy at a lower dosage is as effective as natural ACTH therapy at a higher dosage. Considering the adverse effects and the benefits for seizure control, the ACTH dosage of 0.0125 mg/kg/d (synthetic ...Continue Reading

Citations

Jan 24, 2007·Epilepsia·Shin-Ichiro HamanoYoshikatsu Eto
May 9, 2012·Current Opinion in Neurobiology·Pedro R Olivetti, Jeffrey L Noebels
Apr 29, 2014·Seizure : the Journal of the British Epilepsy Association·Miho FukuiTakeshi Okinaga
Oct 5, 2010·Pharmacological Reports : PR·Radosław ZarczukKinga K Borowicz
Mar 14, 2017·Clinical Neuropharmacology·Ji Min SongMin Jung Chang
Jan 5, 2008·Journal of Child Neurology·Arthur Partikian, Wendy G Mitchell
Jan 30, 2010·Journal of Human Genetics·Yuta KomoikeToshiyuki Yamamoto
Nov 14, 2018·Journal of Materials Chemistry. B, Materials for Biology and Medicine·Chao-Qun YouBai-Wang Sun
Apr 23, 2013·The Annals of Pharmacotherapy·Nicole A ShumiloffKalen B Manasco
Nov 1, 2017·Clinical Drug Investigation·Renato D'AlonzoSusanna Esposito
Dec 29, 2020·Seizure : the Journal of the British Epilepsy Association·Atsuro DaidaKenjiro Kikuchi

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