Response to sequential treatment with prednisolone and vigabatrin in infantile spasms

Aim To report response to first treatment in infants with infantile spasms (IS), including incremental benefit of prednisolone 60 mg/day and vigabatrin following prednisolone 40 mg/day failure in infants commenced on the United Kingdom Infantile Spasms Study (UKISS) treatment sequence. Methods In th...

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Bibliographic Details
Published in:Journal of paediatrics and child health 2022-12, Vol.58 (12), p.2197-2202
Main Authors: Dzau, Winston, Cheng, Sally, Snell, Penny, Fahey, Michael, Scheffer, Ingrid E, Harvey, A Simon, Howell, Katherine B
Format: Article
Language:English
Subjects:
Anticonvulsants - adverse effects
Babies
Clinical outcomes
Drug therapy
Humans
Infant
infantile spasms
Original
Pediatrics
prednisolone
Prednisolone - therapeutic use
Recurrence
Retrospective Studies
Spasm - chemically induced
Spasm - complications
Spasm - drug therapy
Spasms, Infantile - chemically induced
Spasms, Infantile - complications
Spasms, Infantile - drug therapy
Steroids
treatment
vigabatrin
Vigabatrin - adverse effects
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Summary:Aim To report response to first treatment in infants with infantile spasms (IS), including incremental benefit of prednisolone 60 mg/day and vigabatrin following prednisolone 40 mg/day failure in infants commenced on the United Kingdom Infantile Spasms Study (UKISS) treatment sequence. Methods In this retrospective analysis, we compared effectiveness of prednisolone, vigabatrin and nonstandard treatments as first treatment for IS. In infants who commenced the UKISS treatment sequence, we evaluated response to each step. Primary outcome was spasm cessation after 42 days. Secondary outcomes were severe side effects and spasm relapse after 42 days. Results Treatment response data were available for 151 infants. First treatment was prednisolone in 99 infants, vigabatrin in 18 and nonstandard treatment in 34. The rate of spasm cessation with first treatment was significantly higher with prednisolone (62/99, 63%) than vigabatrin (5/18, 28%, P = 0.01) or nonstandard treatment (2/34, 5.9%, P 
ISSN:1034-4810
1440-1754
DOI:10.1111/jpc.16181