ACTH vs Prednisolone in West Syndrome

In this week's ICNTN-FLICNA Journal Club Drs Bina Thakor, Kavita Srivastava & Jitendra Sahu will be discussing
Sumanasena SP, Wanigasinghe J, Arambepola C, Sri Ranganathan S, Muhandiram E (2021) Effect of intramuscular ACTH versus oral prednisolone on the developmental trajectories of children with West syndrome over 24 months: A randomised control study. Eur J Paediatr Neurol 32 ():98-105. DOI: 10.1016/j.ejpn.2021.04.003 PMID: 33894665.

References

Sumanasena SP, Wanigasinghe J, Arambepola C, Sri Ranganathan S, Muhandiram E (2021) Effect of intramuscular ACTH versus oral prednisolone on the developmental trajectories of children with West syndrome over 24 months: A randomised control study. Eur J Paediatr Neurol 32 ():98-105. DOI: 10.1016/j.ejpn.2021.04.003 PMID: 33894665.

O'Callaghan FJK, Edwards SW, Alber FD, Cortina Borja M, Hancock E, Johnson AL  (2018) Vigabatrin with hormonal treatment versus hormonal treatment alone (ICISS) for infantile spasms: 18-month outcomes of an open-label, randomised controlled trial. Lancet Child Adolesc Health 2 (10):715-725. DOI: 10.1016/S2352-4642(18)30244-X PMID: 30236380.

Wanigasinghe J, Arambepola C, Ranganathan SS, Jayasundara K, Weerasinghe A, Wickramarachchi P (2021) Epilepsy Outcome at Four Years in a Randomized Clinical Trial Comparing Oral Prednisolone and Intramuscular ACTH in West Syndrome. Pediatr Neurol 119 ():22-26. DOI: 10.1016/j.pediatrneurol.2021.01.008 PMID: 33836476.

Extract: "A majority of children diagnosed with West syndrome continued to have seizures at age four years, although most were controlled on antiseizure medication"

Wanigasinghe J, Arambepola C, Ranganathan SS, Sumanasena S (2017) Randomized, Single-Blind, Parallel Clinical Trial on Efficacy of Oral Prednisolone Versus Intramuscular Corticotropin: A 12-Month Assessment of Spasm Control in West Syndrome. Pediatr Neurol 76 ():14-19. DOI: 10.1016/j.pediatrneurol.2017.07.008 PMID: 28927673.

Extract: "Control of spasms at three months was significantly better if initially treated with prednisolone"

Wanigasinghe J, Arambepola C, Sri Ranganathan S, Sumanasena S, Muhandiram EC (2014) The efficacy of moderate-to-high dose oral prednisolone versus low-to-moderate dose intramuscular corticotropin for improvement of hypsarrhythmia in West syndrome: a randomized, single-blind, parallel clinical trial. Pediatr Neurol 51 (1):24-30. DOI: 10.1016/j.pediatrneurol.2014.03.014 PMID: 24938136.

Extract: "Hypsarrhythmia severity score improved significantly with both hormonal therapies, but this improvement was significantly better with oral prednisolone than intramuscular adrenocorticotrophin hormone"