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Corticotrophin-ACTH in Comparison to Prednisolone in West Syndrome – A Randomized Study

  • Vykuntaraju K. Gowda
  • Vindhya Narayanaswamy
  • Sanjay K. Shivappa
  • Naveen Benakappa
  • Asha Benakappa
Original Article
  • 71 Downloads

Abstract

Objective

To compare the outcomes of adrenocorticotrophic hormone (ACTH) and Prednisolone therapy in children with West syndrome.

Methods

The study was done at a tertiary health centre for children. The pediatric neurologist at the centre enrolled children into the study based on the inclusion and exclusion criteria. They were evaluated in detail, classified according to etiologic type and then, randomly assigned into two treatment groups, either ACTH or Prednisolone. They were followed at regular intervals till 6 mo.

Results

There was no difference between ACTH and Prednisolone groups with respect to all the outcomes measured. Cessation of spasms was achieved in 6/15 (40%) in Prednisolone group and 9/18 (50%) in ACTH group (p = 0.3906). The average time for achieving cessation was 6.9 and 8 d in ACTH and Prednisolone groups respectively (p = 0.7902). The relapse rates were 18.18 and 50% in ACTH and Prednisolone groups respectively (p = 0.28). The side-effects profile, subsequent epilepsy rates and improvement in milestones were similar in both the treatment groups.

Conclusions

There is no significant difference in children treated with ACTH and Prednisolone. Study results cannot be generalized due to small sample size. However, Prednisolone can be a suitable alternative to ACTH in resource poor settings.

Keywords

ACTH Prednisolone West syndrome Infantile spasms 

Notes

Authors’ Contributions

VKG: Concept and designed the study; VN: Collected the data and helped in data analysis; SKS: Analyzed the data and drafted the manuscript; NB: Concept of study and supervised seizure control; AB: Edited and refined the draft. VKG will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

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Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  1. 1.Division of Pediatric Neurology, Department of PediatricsIndira Gandhi Institute of Child HealthBangaloreIndia
  2. 2.Department of PediatricsIndira Gandhi Institute of Child HealthBangaloreIndia

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