Article, published in Healio
Adrenocorticotropic hormone and oral steroids demonstrated superiority compared with non-standard therapy for the initial treatment of infantile spams in a prospective, multicenter observational cohort study published in Neurology.
“There are three recommended first treatments for infantile spasms: oral corticosteroids (typically prednisolone in the United States), adrenocorticotropic hormone (ACTH) and vigabatrin. Each medication has a different proposed mechanism of action,” the researchers wrote. “Our published analysis of a rigorous prospective multicentered observational study of infants with infantile spasms (the National Infantile Spasms Consortium; NISC) suggested the superiority of ACTH over other treatments. However, our findings were based on a preliminary analysis of an active registry and did not fully account for treatment selection bias and center-to-center variations.”
“We provide real-world head-to-head comparisons of different treatments for infantile spams. Among children with infantile spasms, treatment with anything other than the three recommended therapies resulted in a dismal response: Only 4 of 51 were free from treatment failure,” Dr. Zachary Grinspan and colleagues wrote. “By our estimates, ACTH would have led to freedom from failure in 20 of the 51 and oral steroids would have led to freedom from failure in 19 of the 51. The E-values were high (9.2 and 9), suggesting that unmeasured confounding is unlikely to explain away these findings.”