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. 2023 Mar 9;7(1):29-35.
doi: 10.1002/ped4.12368. eCollection 2023 Mar.

Response to magnesium sulfate and adrenocorticotropic hormone combination therapy for infantile spasms with failed first-line treatments

Qiuhong Wang  1 , Wen He  1 , Yangyang Wang  1 , Liying Liu  1 , Mengna Zhang  1 , Xiaoyan Yang  1 , Liping Zou  1   2
Affiliations

Response to magnesium sulfate and adrenocorticotropic hormone combination therapy for infantile spasms with failed first-line treatments

Qiuhong Wang et al. Pediatr Investig. .

Abstract

Importance: Infantile spasm (IS) is a kind of refractory epilepsy. The first-line treatments for IS are adrenocorticotropic hormone (ACTH), oral corticosteroids, and vigabatrin.

Objective: This study aimed to evaluate the efficacy of magnesium sulfate and ACTH (MgSO4+ACTH) combination therapy in patients with IS who failed first-line treatments.

Methods: In this retrospective study, the clinical data of patients with IS who failed first-line treatments were collected in the Chinese PLA General Hospital. Patients received MgSO4+ACTH combination therapy after first-line treatments failed. The course of treatments was 2 weeks. The therapeutic dose of ACTH and MgSO4 was 2.5 U·kg-1·d-1 and 0.25 g·kg-1·d-1, respectively.

Results: A total of 229 patients with IS who failed the first-line treatments were collected. At the end of the MgSO4+ACTH combination treatment, the seizure-free rate was 48.5% (111/229), and the resolution of hypsarrhythmia on electroencephalogram (EEG) was 72.1% (165/229). About 21.4% (49/229) of patients showed side effects, including infectious diseases, hypokalemia, and diarrhea.

Interpretation: For patients with IS who failed first-line treatments, in terms of the seizure-free rate and resolution of hypsarrhythmia on EEG, MgSO4+ACTH combination therapy can be considered.

Keywords: Adrenocorticotropic hormone; Efficacy; Infantile spasms; Magnesium sulfate; Treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of participant eligibility and inclusion. ACTH, adrenocorticotrophic hormone; OCS, oral corticosteroids; VGB, vigabatrin; MgSO4, magnesium sulfate.
See this image and copyright information in PMC

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