Abstract Details

Title Corticotherapy Versus Adrenocorticotrophic Hormone for the Treatment of West Syndrome: a Systematic Review and Meta-analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P12 - Poster Session 12 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-006

Objective The objective was to present an updated review comparing the therapeutic and adverse effects of adrenocorticotropic hormone (ACTH) therapy versus corticosteroids in children with Infantile Spasms.

Background Although it is known that the most commonly used therapies for West Syndrome are intramuscular ACTH and oral prednisolone, there is still controversy in the literature regarding the equivalence of their effects. The importance of elucidating the superiority of one drug over the other lies in the difference in their costs.

Design/Methods PubMed, EMBASE, and Cochrane Central were used as search tools. The outcomes of interest selected were spasm cessation on day 14 of therapy, cessation of hypsarrhythmia and adverse effects such as weight gain, infection, irritability, and hypertension. Statistical analysis was performed using RevMan 5.1.7.

Results 1,998 articles were screened and 7 RCTs and 429 patients were included. Compared with Corticoids, ACTH was associated with a bigger reduction in weight gain (RR 1.41; 95% CI 1.01 - 1.97; p=0.04; I²=0%). There was no significant difference in cessation of spasms on day 14 (OR 0.91; 95% CI 0.47 - 1.47; p=0.79), hypsarrhythmia (OR 0.97; 95% CI 0,22 - 4.34), irritability (RR 0.78; 95% CI 0.30 - 1.99), hypertension (RR 0.64; 95% CI 0.35 - 1.15; p=0.14), and infection (RR 0.69; 95% CI 0.19 - 2.50; p=0.57).

Conclusions

This study provides robust evidence regarding the safety and efficacy of ACTH or corticoids in children with epileptic spasms. However, the significant heterogeneity between studies restricts the analysis, emphasizing the necessity for additional research to assess the best option to treat infantile spasms.

Authors/Disclosures
Aishwarya Koppanatham, MBBS PRESENTER	Ms. Koppanatham has nothing to disclose.
Elizabeth H. de Farias II, medical academic	Mrs. de Farias has nothing to disclose.
Altair P. de Melo Neto, Student	Mr. de Melo Neto has nothing to disclose.
Julia Cappi Aguiar Moraes Souza, MS	Ms. Cappi Aguiar Moraes Souza has nothing to disclose.
Raphael Besborodco, MD (NYU)	Dr. Besborodco has nothing to disclose.
Gabrielle d. Rocha, PhD	Prof. Rocha has nothing to disclose.

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