Vigabatrin Versus ACTH as First‐Line Treatment for Infantile Spasms: A Randomized, Prospective Study

Vigevano, Federico; Cilio, Maria Roberta

doi:10.1111/j.1528-1157.1997.tb00063.x

Cited by 250 publications

(230 citation statements)

References 14 publications

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“…In one prospective, randomised study from Italy [39] (Class III), 42 infants received vigabatrin 100-159 mg/kg/day or ACTH depot 10 IU intramuscularly once daily for 20 days. The effects (cessation of the spasms) were 48 % versus 74 % in favour of ACTH (p = 0.007).…”

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 99%

“…Results from two Class III studies (N = 107 and 28, respectively) indicate that hormonal therapy leads to resolution of spasms three times more rapidly and in more infants than vigabatrin [22,39].…”

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 99%

“…After pooling the data of eight separate prospective and retrospective studies, vigabatrin had a good response on spasms in 44 % of 478 patients [11,22,31,39,40,[45][46][47]. In the pooled data of nine separate prospective and retrospective studies, ACTH had a good response on spasms in 59 % of 476 patients [22, 24, 26-29, 34, 48, 49].…”

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 99%

“…The common side effects of both drugs are irritability, sleep disturbances and drowsiness [27,39,40,48,66]. Both drugs also have severe side effects.…”

Section: Side Effects Of Corticosteroids and Vigabatrinmentioning

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: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 99%

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 99%

Section: Is Acth More Effective Than Vigabatrin For Shortterm Treatmementioning

confidence: 99%

“…The common side effects of both drugs are irritability, sleep disturbances and drowsiness [27,39,40,48,66]. Both drugs also have severe side effects.…”

Section: Side Effects Of Corticosteroids and Vigabatrinmentioning

confidence: 99%

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Recent Advances in the Pharmacotherapy of Infantile Spasms

Riikonen

2014

CNS Drugs

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“…Vigevano e Cilio 7 num estudo comparativo entre ACTH e vigabatrina, observaram superioridade do primeiro nas crises relacionadas à síndrome hipóxico-isquêmica mas em nossos pacientes não notamos relação entre a etiologia, a resposta ao tratamento e a recorrência. No esquema de tratamento utilizado, em que as doses são diárias apenas nas duas primeiras semanas do tratamento, observamos uma incidência de efeitos colaterais de 70%, considerada alta em relação a outras séries 7 , mas nenhum deles foi considerado grave ou indicativo de interrupção. Como em outras séries, é necessário o uso de drogas anti-epilépticas tradicionais no tratamento das epilepsias na infância.…”

Section: Discussionunclassified

Espasmos infantis: experiência em treze casos

Fonseca

Oliveira²

2000

Arq. Neuro-Psiquiatr.

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RESUMO -Os espasmos infantis são crises típicas da primeira infância e constituem patologia grave, com prognóstico sombrio. Apresentamos a experiência no tratamento de 13 casos novos atendidos no Serviço de Neurologia Infantil do Centro Geral de Pediatria FHEMIG de Belo Horizonte no ano de 1997, bem como revisão da literatura sobre o assunto. Após propedêutica adequada encontramos 12 casos considerados sintomáticos e 1 criptogenético. Todos os casos foram tratados com ACTH durante 6 semanas, associado a drogas antiepilépticas orais de manutenção em mono ou politerapia. Os resultados com o ACTH foram excelentes num momento inicial, com resposta completa em todos os casos e efeitos colaterais que não contra-indicaram o tratamento. Porém houve índice de recorrência de 55%, sendo usada como droga de segunda linha a vigabatrina em 5 casos, com controle de 4 deles. Todos os casos apresentaram atraso do desenvolvimento neuropsicomotor.PALAVRAS-CHAVE: espasmos infantis, síndrome de West, ACTH. Infantile spasms: experience in thriteen casesABSTRACT -Infantile spasms are typical crisis found in the childhood being a serious pathology with an obscure prognosis. We present the experience of the Service of Neuropediatrics in the Pediatric General Center, Belo Horizonte -Brasil, during the year of 1997, with a review of the literature about. After appropriate propaedeutics, were found 12 cases considered symptomatics and 1 case cryptogenic. All these cases were treated with ACTH during 6 weeks associated with oral antiepileptic drugs in mono or polytherapy for maintenance. We had excellent results using ACTH at the beginning of the treatment, obtaining good results in all of the cases with some side effects that were not important enough to interrupt the treatment. However, there was a recurrence rate of 55% and vigabatrin was used as second option, controlling 4 of the 5 cases. All the cases showed retardation of the neuropsychomotor development.

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Do New Antiepileptic Drugs Justify Their Expense?

Chadwick

1998

Arch Neurol

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Vigabatrin Versus ACTH as First‐Line Treatment for Infantile Spasms: A Randomized, Prospective Study

Abstract: Our data lend further support to the view that VGB may be considered a first-choice drug in the treatment of IS.

Cited by 250 publications

References 14 publications

Recent Advances in the Pharmacotherapy of Infantile Spasms

Recent Advances in the Pharmacotherapy of Infantile Spasms

Espasmos infantis: experiência em treze casos

Do New Antiepileptic Drugs Justify Their Expense?

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