Efficacy of pulse methylprednisolone vs adrenocorticotrophic hormone in children with West Syndrome: An open-label pilot trial

Singhi, Pratibha; Gupta, Anju; Rajpurohit, Madan; Saini, Arushi Gahlot; Soni, Vimlesh

doi:10.1016/j.ejpn.2017.04.818

Cited by 2 publications

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“…No statistically significant difference was found in seizure control in these groups. Our study result has similarity with that of Singhi et al 15 who found 50% remission in ACTH in 42.3% and in MP 22.2% at 6 weeks. However, their response rate at two weeks were around 50% in both groups (50% remission).…”

Section: Discussionsupporting

confidence: 92%

“…Some recent studies suggested that intravenous pulse methyl-prednisolone (MP) followed by oral prednisolone is effective for seizure control in WS, which is safe. 14 , 15 However, none of these studies were randomized controlled trial (RCT). On this ground, this study has been done to investigate the efficacy, safety and non-inferiority of pulse MP in WS in comparison to the standard drug ACTH.…”

Section: Introductionmentioning

confidence: 99%

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Pulse Methylprednisolone with Oral Prednisolone versus Adrenocorticotropic Hormone in Children with West Syndrome: a Randomized Controlled Trial

Fatema¹,

Rahman²,

Hossain³

et al. 2021

J Epilepsy Res

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Background and Purpose: West syndrome is an epileptic encephalopathy of infancy. According to guidelines, adrenocorticotrophic hormone (ACTH) is probably effective for the short-term management of infantile spasm, but there is little uniformity in treatment due to variable response. This study has been done to evaluate the efficacy of pulse methylprednisolone as compared to ACTH in children with West syndrome.Methods: Children between 3 months to 24 months with the diagnosis of West syndrome were included and ACTH and pulse methyl prednisolone followed by oral prednisolone were given after randomization. Total duration of treatment was 6 weeks in both groups.Results: Total 87 children were enrolled; 12 patients lost in follow up. Finally, 43 received ACTH and 32 received pulse methylprednisolone. In pulse methylprednisolone group, 28.13% showed 50-80% response, 28.13% showed 80-99% response and 21.87% patients showed 100% response. In ACTH group, 41.86% showed 50-80% response, 25.58% showed 80-99% response and only 3 (6.97%) patients showed 100% response. Methylprednisolone treatment regimen did not cause significant or persistent adverse effects.Conclusions: Pulse methylprednisolone followed by oral prednisolone for 6 weeks is as effective as ACTH. Thus, methylprednisolone therapy can be an important alternative to ACTH.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Pulse Methylprednisolone with Oral Prednisolone versus Adrenocorticotropic Hormone in Children with West Syndrome: a Randomized Controlled Trial

Fatema¹,

Rahman²,

Hossain³

et al. 2021

J Epilepsy Res

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Pulse methylprednisolone plus low-dose prednisolone versus low-dose prednisolone alone for treatment of children with West syndrome: A single-center, open-label randomized controlled trial

Kaushik¹,

Kumari²,

Nanda³

et al. 2022

JOPN

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Background: There are preliminary reports of the benefit of additional pulse methylprednisolone (MP) to oral prednisolone in the treatment of West syndrome. Aim: To compare the efficacy and safety of intravenous pulse MP followed by low-dose prednisolone versus low-dose prednisolone alone for children with West syndrome. Materials and Methods: This randomized, open-labeled, controlled clinical trial was conducted among children aged two months to 30 months with a diagnosis of West syndrome. They were randomized to either of pulse MP (30 mg/kg for 3 days) followed by low-dose prednisolone (2 mg/kg) [n = 26] or low-dose prednisolone (2 mg/kg) alone [n = 24] for four weeks. Results: The efficacy of pulse MP was comparable with oral prednisolone in terms of spasms cessation (11 [45.8%] vs. 7 [26.9%]; RRR [95% confidence interval [CI]: 0.74 [0.47–1.14]; P = 0.24), more than 50% spasms reduction (16 [66.6%] vs. 11 [42.3%]; RRR [95% CI]: 0.57 [0.31–1.12]; P = 0.09), more than 90% reduction (11 [42.8%] vs. 7 [26.9%]; RRR [95% CI]: 0.74 [0.47–1.14]; P = 0.24), and primary electroclinical remission (5 [20.8%] vs. 2 [7.6%]; RRR [95% CI]: 0.85 [0.68–1.08]; P = 0.21). The adverse effect profile was comparable in the two groups. Conclusion: Pulse MP therapy followed by oral prednisolone in low-dose (2 mg/kg) was as effective as low-dose prednisolone (2 mg/kg) therapy alone in West syndrome. Although pulse MP did not result in any adverse outcome, routine use of the same before initiation of oral prednisolone needs further studies with a larger sample size; longer follow-,up and comparative trial with high dose steroids (4 mg/kg).

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Efficacy of pulse methylprednisolone vs adrenocorticotrophic hormone in children with West Syndrome: An open-label pilot trial

Cited by 2 publications

References 0 publications

Pulse Methylprednisolone with Oral Prednisolone versus Adrenocorticotropic Hormone in Children with West Syndrome: a Randomized Controlled Trial

Pulse Methylprednisolone with Oral Prednisolone versus Adrenocorticotropic Hormone in Children with West Syndrome: a Randomized Controlled Trial

Pulse methylprednisolone plus low-dose prednisolone versus low-dose prednisolone alone for treatment of children with West syndrome: A single-center, open-label randomized controlled trial

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