Response To Treatment In A Prospective National Infantile Spasms Cohort

This study evaluates early and sustained response to initial treatments and addresses both clinical remission and electrographic resolution of hypsarhythmia. Secondarily, it assesses whether response to treatment differs by etiology or developmental status. Methods: The National Infantile Spasms Consortium established a multi‐center, prospective database enrolling infants with new diagnosis of infantile spasms. Children were considered responders if there was clinical remission and resolution of hypsarhythmia that was sustained at three months after first treatment initiation. Standard treatments of ACTH, oral corticosteroids, and vigabatrin were considered individually, and all other non‐standard therapies were analyzed collectively. Developmental status and etiology were assessed. We compared response rates by treatment group using Chi‐square tests and multivariable logistic regression models. Results: Two hundred and thirty infants were enrolled from 22 centers. Overall, 46% of children receiving standard therapy responded compared to only 9% who responded to non‐standard therapy (p<0.001). 55% of infants receiving ACTH as initial treatment responded, compared to 39% for oral corticosteroids, 36% for vigabatrin, and 9% for other (p<0.001). Neither etiology nor development significantly modified the response pattern by treatment group. Interpretation: Response rate varies by treatment choice. Standard therapies should be considered as initial treatment for inf...
Source: Annals of Neurology - Category: Neurology Authors: Tags: Research Article Source Type: research