Developmental and epilepsy outcomes at age 4 years in the UKISS trial comparing hormonal treatments to vigabatrin for infantile spasms: a multi-centre randomised trial

Darke, Katrina; Edwards, Stuart W; Hancock, Eleanor; Johnson, Anthony L.; Kennedy, Colin; Lux, Andrew; Newton, Richard; O'Callaghan, Finbar; Verity, Christopher; Osborne, J. P.

doi:10.1136/adc.2009.160606

Cited by 144 publications

(139 citation statements)

References 13 publications

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“…Better initial control of the spasms by hormonal treatment was associated with significantly better cognitive outcome at 14 months [50] and 4 years of age in patients with 'nonidentified aetiology' [51] in the UK Study. Hormonal treatment may lead to improved developmental outcome in those with no identified aetiology [50,51].…”

Section: Cryptogenic Spasmsmentioning

confidence: 86%

“…As a continuation of the aforementioned study, the same study group published the results of follow-up at 14 months and 4 years [50,51] (Class II and Class I, respectively). At 14 months of treatment, there was only a minimal difference in the relapse-free response rate between vigabatrin and hormonal treatments and in terms of seizure frequency [50].…”

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 90%

“…At 14 months of treatment, there was only a minimal difference in the relapse-free response rate between vigabatrin and hormonal treatments and in terms of seizure frequency [50]. However, cognitive outcome was better after initial ACTH than vigabatrin in the unknown aetiology subgroup, but not in the identified aetiology subgroup [50,51]. This might be explained by earlier cessation of the spasms in the ACTH/hormone group.…”

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 94%

“…Furthermore, in the cryptogenic group (N = 77) of the UKISS study, Vineland Adaptive Behavioral Scores (VABS) at 4 years were 96 in the hormonal group versus 63 in the vigabatrin treatment group (p = 0.033) [51]. The UKISS Class II study showed that cognitive outcome was better after initial ACTH than vigabatrin in the cryptogenic subgroup but not in the identified aetiology subgroup [51].…”

Section: Tuberous Sclerosis (Ts)mentioning

confidence: 97%

“…Hormonal treatment may lead to improved developmental outcome in those with no identified aetiology [50,51]. ACTH might be a drug of choice for cryptogenic infantile spasms [7].…”

Section: Cryptogenic Spasmsmentioning

confidence: 99%

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Recent Advances in the Pharmacotherapy of Infantile Spasms

Riikonen

2014

CNS Drugs

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Adrenocorticotrophic hormone (ACTH), oral corticosteroids and vigabatrin are now first-line treatments for infantile spasms in the US and Europe. There is now increased knowledge regarding the role of ACTH, corticosteroids and vigabatrin (e.g. efficacy, doses, side effects, treatment in specific aetiological subtypes of infantile spasms), and other antiepileptic drugs (i.e. topiramate, valproate, zonisamide, sulthiame, levetiracetam, lamotrigine, pyridoxine, ganaxolone), as well as adjunctive flunarizine and novel drugs not yet in clinical use for infantile spasms (i.e. pulse rapamycin and melanocortin receptor agonists). The existence of a latent period, weeks to months following a precipitating brain insult, raises the possibility of preventive interventions. Recent experimental data emerging from animal models of infantile spasms have provided optimism that new and innovative treatments can be developed, and knowledge that drug treatment can affect long-term cognitive outcome is increasing. The aim of this article is to review recent developments in the pharmacotherapy of infantile spasms and to highlight the practical implications of the latest research.

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Section: Cryptogenic Spasmsmentioning

confidence: 86%

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 90%

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 94%

Section: Tuberous Sclerosis (Ts)mentioning

confidence: 97%

“…Hormonal treatment may lead to improved developmental outcome in those with no identified aetiology [50,51]. ACTH might be a drug of choice for cryptogenic infantile spasms [7].…”

Section: Cryptogenic Spasmsmentioning

confidence: 99%

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