Hormones better than vigabatrin for treating infantile spasms
Hormonal treatments are more effective than vigabatrin in treating infantile spasms, a new study has found (The
Lancet 2004;364;1773).
The randomised, placebo-controlled trial compared the effectiveness of
vigabatrin and hormonal treatment (prednisolone or tetracosactide) in
107 infants. Cessation of spasms by days 13 and 14 occurred in 73 per
cent of patients assigned hormonal treatments and in 54 per cent of patients
assigned vigabatrin.
Since the 1950s, the usual treatment for infantile spasms has been either
intramuscular adrenocorticotropic hormone or oral corticosteroids. In
the 1990s, vigabatrin was introduced as an effective treatment. However,
since 1997, irreversible visual field defects have been identified in
30 per cent of adults treated with vigabatrin and so a comparison of
the two treatments was necessary.
In the study, adverse events were common with both treatments; they were
reported in 55 per cent of infants on hormonal treatments and 54 per
cent of patients on vigabitran. Infants showed increased irritability
and appetite on hormonal treatments and more drowsiness on vigabatrin.
However, the greater effectiveness of hormonal treatments in stopping
spasms leads Andrew Lux of the University of Bath and his co-authors
to conclude that hormonal treatments offer an advantage in the initial
control of infantile spasms. |
The
Pharmaceutical Journal
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