Multiple Sclerosis Treatment of Acute Exacerbations With Corticotrophin (A.C.T.H.)

Miller, Henry; Newell, D. J.; Ridley, Alan

doi:10.1016/s0140-6736(61)91030-3

Cited by 116 publications

(60 citation statements)

References 6 publications

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“…These conclusions are contrary to general opinion and to the conclusions reached in other trials, which have been that ACTH speeds recovery in acute episodes of multiple sclerosis (Miller et al, 1961;Rinne et al, 1968) including acute optic neuritis (Rawson et al, 1966(Rawson et al, , 1969.…”

Section: Discussioncontrasting

confidence: 93%

“…This is especially true of acute episodes which show a natural tendency to remit. Controlled trials of ACTH were said to show more treated patients achieving greater improvement in acute exacerbations of multiple sclerosis (Miller et al, 1961;Rinne et al, 1968) but the total number of patients in both series was only 76, and in the series of Miller et al the controls were poorly matched. Although the results of the Cooperative Study (1970) in the U.S.A. tended to support this, the benefits over placebo were marginal and it was concluded that, for the individual patient with an acute exacerbation of multiple sclerosis, there is 'little evidence to justify the enthusiastic administration of ACTH'.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A trial of corticotrophin gelatin injection in acute optic neuritis

Bowden

Friedmann

et al. 1974

Journal of Neurology, Neurosurgery & Psychiatry

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SYNOPSIS The effect of a 30 day course of corticotrophin gelatin injections on the natural history of acute unilateral optic neuritis in 27 patients is reported. A further 27 patients received inert injections in a double-blind control. Measurements were made on visual acuity, visual field, macular threshold, and colour vision, and the development of optic atrophy and other neurological episodes was recorded. No significant differences were found between treated and control groups at intervals up to two years from the start of the trial. The criteria for inclusion of patients are given and it is concluded that corticotrophin has no effect on the natural history of the condition as defined.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

A trial of corticotrophin gelatin injection in acute optic neuritis

Bowden

Friedmann

et al. 1974

Journal of Neurology, Neurosurgery & Psychiatry

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“…Overall, the four trials of MP (total n = 140) and two trials of ACTH (total n = 237) supported similar benefits of MP and ACTH in acute MS exacerbations [Durelli et al 1985;Filipovic et al 1997;Miller et al 1961;Milligan et al 1987;Rose et al 1970;Sellebjerg et al 1998]. In this review, insomnia was included in the category of psychiatric disturbances.…”

Section: Discussionmentioning

confidence: 86%

Clinical experience with repository corticotropin injection in patients with multiple sclerosis experiencing mood changes with intravenous methylprednisolone: a case series

Murray¹,

Woo²

2015

Ther Adv Neurol Disord

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The elevated prevalence of neuropsychiatric symptoms and disorders among patients with multiple sclerosis (MS) is well recognized, as are potential neuropsychiatric side effects of treatment with corticosteroids. Both methylprednisolone (MP) and repository corticotropin injection (HP Acthar® gel) have demonstrated efficacy in reducing short-term disability after exacerbations of MS. Although historical data are limited, repository corticotropin injection has not generally been associated with detrimental neuropsychiatric effects. We describe six cases of patients with relapsing-remitting MS who had previously experienced detrimental mood changes with MP treatment. Some of these patients had previous histories of mood disorders or other neuropsychiatric symptoms prior to MS diagnosis. All six patients were subsequently treated with repository corticotropin injection for MS exacerbations and each demonstrated improvements in MS symptoms. This clinical experience suggests that repository corticotropin injection should be considered as an alternative for patients who do not tolerate corticosteroids or have difficulties associated with intravenous medication. Furthermore, the rate of neuropsychiatric side effects observed in these patients was low. These observations support repository corticotropin injection as a viable alternative for the treatment of acute exacerbations of MS, particularly in patients who have a history of neuropsychiatric disorders or symptoms either independently or in response to MP treatment. In reviewing both the published data and our own clinical experience regarding potential neuropsychiatric adverse events with treatment for MS exacerbations, we hope to stimulate further research into the potential efficacy and safety of repository corticotropin injection among patients with some form of neuropsychiatric complications that must be considered when establishing a treatment plan for MS.

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“…The article provides a clear definition of an MS patient experiencing a relapse as an individual with "unequivocal multiple sclerosis, who presented with an assessable new symptom or sign of less than 14 days' duration and showing no spontaneous improvement" [7]. The 40 patients with such presentation "were randomly allocated to two treatment groups, one receiving corticotrophin gel (ACTH gel) and the other comparable injections of saline" [7].…”

Section: History and Practice Of Ms Relapse Treatments: From Adrenocomentioning

confidence: 99%

“…The 40 patients with such presentation "were randomly allocated to two treatment groups, one receiving corticotrophin gel (ACTH gel) and the other comparable injections of saline" [7]. The patients treated with ACTH gel were given 60 units of gel twice daily during the first week of treatment; 40 units twice daily during the second week; and 60, 40, and 20 units on the second, fourth, and sixth days of the third week.…”

Section: History and Practice Of Ms Relapse Treatments: From Adrenocomentioning

confidence: 99%

Treatment of Acute Relapses in Multiple Sclerosis

Berkovich

2016

Translational Neuroimmunology in Multiple Sclerosis

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Multiple Sclerosis Treatment of Acute Exacerbations With Corticotrophin (A.C.T.H.)

Cited by 116 publications

References 6 publications

A trial of corticotrophin gelatin injection in acute optic neuritis

A trial of corticotrophin gelatin injection in acute optic neuritis

Clinical experience with repository corticotropin injection in patients with multiple sclerosis experiencing mood changes with intravenous methylprednisolone: a case series

Treatment of Acute Relapses in Multiple Sclerosis

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