Abstract Details

Title A Randomized Prospective Trial Comparing Repository Corticotropin Injection and Intravenous Methylprednisolone for Neuroprotection in Acute Optic Neuritis

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P17 - Poster Session 17 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-004

Objective To compare the effects of repository corticotropin injection (RCI) and intravenous methylprednisolone (IVMP) on optic nerve injury and patient reported outcomes (PROs) in acute optic neuritis (ON).

Background RCI and IVMP improve the rate but not the extent of visual recovery following acute ON. RCI has adrenal- and melanocortin receptor-stimulating properties that may endow it with unique anti-inflammatory properties relative to IVMP. There are no studies comparing RCI and IVMP in acute ON.

Design/Methods Individuals with acute optic neuritis of less than 2 weeks duration were prospectively enrolled and randomized 1:1 to receive either RCI or IVMP. Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell plus inner plexiform layer thickness (GC+IPL) were serially evaluated by optical coherence tomography (OCT); changes in fatigue, mood, visual function, depression, and quality of life (QOL) were evaluated by validated questionnaires. The primary outcome was the difference in average pRNFL thickness in the affected eye at 6 months.

Results Thirty-seven subjects were enrolled (19 RCI; 18 IVMP); the average time from symptom to treatment was 8.8 days. At 6 months, there was no difference in the loss of average pRNFL thickness in the affected eye (RCI vs. IVMP: -13.1 vs. -11.7 µm, p=0.88) or GC+IPL thickness (RCI vs. IVMP: -13.8 vs. -12.0 µm, p=0.58) between treatment groups. There was no difference in number of eyes with pRNFL swelling between treatment groups at 1 month (RCI vs. IVMP: 12 vs. 13, p=0.73) and 3 months (RCI vs. IVMP: 4 vs. 4, p=0.99). Both treatments resulted in improvement in visual function questionnaires; no differences were noted in measures of QOL, fatigue, and depression.

Conclusions Treatment of acute ON with RCI or IVMP produced no differences in axonal or ganglion cell preservation. Both treatments improved PROs of visual function.

Authors/Disclosures
Jeffrey L. Bennett, MD, PhD, FAAN (University of Colorado School of Medicine) PRESENTER	Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Mitsubishi Tanabe. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immpact Bio. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Chugai. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Beigene. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Imcyse. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MIAC. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CorEvitas. Dr. Bennett has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alexion. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Vindico. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Touch IME. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Efficient LLC. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Pavich. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Marie Bush. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Marks Gray. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Knight, Nicastro, MacKay. The institution of Dr. Bennett has received research support from Alexion. The institution of Dr. Bennett has received research support from Genentech. Dr. Bennett has received intellectual property interests from a discovery or technology relating to health care. Dr. Bennett has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
Christopher S. Mizenko (University of Colorado)	Mr. Mizenko has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Teresa Frohman, PA (Frohman & Frohman, PLLC)	No disclosure on file
Elliot M. Frohman, MD, FAAN	Dr. Frohman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen. Dr. Frohman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Janssen. Dr. Frohman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up To Date. Dr. Frohman has received publishing royalties from a publication relating to health care.
	No disclosure on file

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