Clinical and Economic Evaluation of Repository Corticotropin Injection: A Narrative Literature Review of Treatment Efficacy and Healthcare Resource Utilization for Seven Key Indications

Philbin, Michael; Niewoehner, John; Wan, George J.

doi:10.1007/s12325-017-0569-9

Cited by 24 publications

(20 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Acthar Gel is also US Food and Drug Administration-approved as an adjunctive therapy for shortterm administration in psoriatic and rheumatoid arthritis [23]. In support of the considerably broad clinical utility of Acthar Gel [23,27], several studies have revealed anti-inflammatory and immunomodulatory effects in rodent models of multiple sclerosis, systemic lupus erythematosus, nephrotic syndromes, and rheumatoid arthritis [28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Distinct binding and signaling activity of Acthar Gel compared to other melanocortin receptor agonists

Huang

Galen

Zweifel

et al. 2020

Journal of Receptors and Signal Transduction

View full text Add to dashboard Cite

Purpose: To compare the binding and agonistic activity of Acthar V R Gel and synthetic melanocortin receptor (MCR) agonists and examine how the activity of select agonists affects the in vivo production of corticosterone. Materials and Methods: In vitro binding was determined using concentration-dependent displacement of the ligand [ 125 I]Nle 4 , D-Phe 7-a-melanocyte-stimulating hormone (a-MSH) on cells expressing MC1R, MC3R, MC4R, or MC5R. Functional activity was determined using a time-resolved fluorescence cyclic adenosine monophosphate (cAMP) assay in cells expressing MC1R, MC2R, MC3R, MC4R, or MC5R. In vivo corticosterone analyses were performed by measuring plasma corticosterone levels in Sprague Dawley rats. Results: Acthar Gel and synthetic MCR agonists exhibited the highest binding at MC1R, lowest binding at MC5R, and moderate binding at MC3R and MC4R. Acthar Gel stimulated the production of cAMP in all 5 MCR-expressing cell lines, with MC2R displaying the lowest level of full agonist activity, 3-, 6.6-, and 10-fold lower than MC1R, MC3R, and MC4R, respectively. Acthar Gel was a partial agonist at MC5R. The synthetic MCR agonists induced full activity at all 5 MCRs, with the exception of a-MSH having no activity at MC2R. Acthar Gel treatment had less of an impact on in vivo production of corticosterone compared with synthetic ACTH 1-24 depot. Conclusions: Acthar Gel bound to and activated each MCR tested in this study, with partial agonist activity at MC5R and the lowest level of full agonist activity at MC2R, which distinguished it from synthetic MCR agonists. The minimal activity of Acthar Gel at MC2R corresponded to lower endogenous corticosteroid production.

show abstract

Section: Introductionmentioning

confidence: 99%

Distinct binding and signaling activity of Acthar Gel compared to other melanocortin receptor agonists

Huang

Galen

Zweifel

et al. 2020

Journal of Receptors and Signal Transduction

View full text Add to dashboard Cite

show abstract

“…Although RCI has been approved to treat inflammatory and autoimmune diseases for more than 60 years, recent progress in understanding melanocortin receptors and the effects of RCI in modulating immune responses has led to increased interest in RCI as a therapeutic choice [25]. The role of RCI in the overall treatment algorithm is considered in the article on the treatment algorithm for sarcoidosis in this issue of the European Respiratory Review [26].…”

Section: Discussionmentioning

confidence: 99%

Management of repository corticotrophin injection therapy for pulmonary sarcoidosis: a Delphi study

et al. 2020

View full text Add to dashboard Cite

In patients treated with repository corticotrophin injection (RCI) for pulmonary sarcoidosis, effective management of adverse events may improve adherence. However, management of adverse events may be challenging due to limitations in real-world clinical experience with RCI and available published guidelines.We surveyed 12 physicians with a modified Delphi process using three questionnaires. Questionnaire 1 consisted of open-ended questions. Panellists' answers were developed into a series of statements for Questionnaires 2 and 3. In these, physicians rated their agreement with the statements using a Likert scale.Key consensus recommendations included a starting dose of 40 units twice a week for patients with less severe disease, continued at a maintenance dose for patients who responded, particularly those with chronic refractory sarcoidosis. Panellists reached consensus that concomitant steroids should be quickly tapered in patients receiving RCI, but that concomitant use of immunosuppressive medications should be continued. Panellists developed consensus recommendations for adverse event management, and reached consensus that RCI should be down-titrated or discontinued if other interventions for the adverse effects fail or if the adverse effect is severe.In the absence of clinical evidence, our Delphi consensus opinions may provide practical guidance to physicians on the management of RCI to treat pulmonary sarcoidosis.

show abstract

“…ACTH is used in the diagnostics and treatment of pituitary-adrenal cortex diseases and other disorders, including autoimmune polymyositis, systemic lupus, rheumatoid arthritis, Crohn's disease, and ulcerative colitis, as well as inflammatory and allergic processes of the eye [20,21]. Three preparations containing ACTH are registered and used: H.P.…”

Section: Introductionmentioning

confidence: 99%

“…Three preparations containing ACTH are registered and used: H.P. Acthar ® Gel, Cortrosyn TM, and Synacthen ® Depot [21,22]. All these preparations are injected.…”

Section: Introductionmentioning

confidence: 99%

Development and Study of Semi-Solid Preparations Containing the Model Substance Corticotropin (ACTH): Convenience Application in Neurodegenerative Diseases

2020

View full text Add to dashboard Cite

Corticotropin (ACTH, previously an adrenocorticotropic hormone) is used in the diagnosis and treatment of pituitary gland disorders, adrenal cortex disorders, and other diseases, including autoimmune polymyositis, systemic lupus erythematosus, rheumatoid arthritis, Crohn’s disease, and ulcerative colitis. So far, the ointment dosage form containing ACTH for use on the skin is unknown. Therefore, it seems appropriate to develop a semi-solid formulation with corticotropin. Emulsion ointments were prepared using an Unguator based on the cream base Lekobaza® containing corticotropin in different concentrations, and then the physical and chemical parameters of the ointment formulations, such as pH, spreadability, rheological properties, and texture analysis, were evaluated. In addition, a USP apparatus 2 with enhancer cells was utilized to study the in vitro drug release characteristics of the selected formulations. All the ointments obtained were characterized by good spreadability and viscosity. An analysis of the ointment texture was performed and the dependence of the tested parameters on the ACTH content in the ointment was demonstrated. Examination of the structure of the ointment showed that a high concentration of ACTH increases the hardness and adhesiveness of the ointment. In turn, it adversely affects the cohesiveness and elasticity of the ointments tested. The results of the release study showed that ACTH is released the fastest from the formulation with the lowest concentration, while the slowest from the ointment with the highest concentration of ACTH.

show abstract

Clinical and Economic Evaluation of Repository Corticotropin Injection: A Narrative Literature Review of Treatment Efficacy and Healthcare Resource Utilization for Seven Key Indications

Cited by 24 publications

References 47 publications

Distinct binding and signaling activity of Acthar Gel compared to other melanocortin receptor agonists

Distinct binding and signaling activity of Acthar Gel compared to other melanocortin receptor agonists

Management of repository corticotrophin injection therapy for pulmonary sarcoidosis: a Delphi study

Development and Study of Semi-Solid Preparations Containing the Model Substance Corticotropin (ACTH): Convenience Application in Neurodegenerative Diseases

Contact Info

Product

Resources

About