Prevention of West Syndrome With Low-dose Adrenocorticotropin Hormone (ACTH)

NCT ID: NCT01367964

Last Updated: 2018-11-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-07-31

Study Completion Date

2018-12-31

Brief Summary

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West syndrome (WS) is a specific type of epilepsy (or seizure disorder) that has three features: infantile spasms (type of seizure), loss of milestones, and a specific pattern on electroencephalogram (EEG or brain wave test) called hypsarhythmia. The purpose of this study is to detect pre-hypsarhythmia in infants at high-risk for WS and determine whether treatment with ACTH will prevent WS.

Detailed Description

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Hypothesis: Preemptive ACTH will halt the evolution of hypsarhythmia and improve the EEG patterns in infants with pre-hypsarhythmic EEG.

Aim. To determine whether a low dose ACTH improves EEG, we will repeat EEG one month after a 2 week course of daily ACTH.

Conditions

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West Syndrome

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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ACTH treatment

Infants with a Type 3 EEG (pre-hypsarhythmia) will be treated with ACTH for 2 weeks.

Group Type EXPERIMENTAL

adrenocorticotropin hormone

Intervention Type DRUG

ACTH 16 units intramuscular injection once daily for 2 weeks

Interventions

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adrenocorticotropin hormone

ACTH 16 units intramuscular injection once daily for 2 weeks

Intervention Type DRUG

Other Intervention Names

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H.P. Acthar® Gel (repository corticotropin injection)

Eligibility Criteria

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Inclusion Criteria

* Infants with pre-hypsarhythmia (Type 3 EEG) between 2 months to 12 months of age.

Exclusion Criteria

* Infants with any of the following diagnoses:
* A previous history of infantile spasms;
* Known inborn error of metabolism;
* Other symptomatic epileptic encephalopathy (e.g. Ohtahara syndrome).
Minimum Eligible Age

2 Months

Maximum Eligible Age

12 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Thrasher Research Fund

OTHER

Sponsor Role collaborator

Ann & Robert H Lurie Children's Hospital of Chicago

OTHER

Sponsor Role lead

Responsible Party

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John J Millichap, MD

Attending Physician, Division of Neurology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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John J. Millichap, MD

Role: PRINCIPAL_INVESTIGATOR

Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine

Sookyong Koh, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine

Doulgas R Nordli, Jr, MD

Role: PRINCIPAL_INVESTIGATOR

Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine

Locations

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Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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SOREL L, DUSAUCY-BAULOYE A. [Findings in 21 cases of Gibbs' hypsarrhythmia; spectacular effectiveness of ACTH]. Acta Neurol Psychiatr Belg. 1958 Feb;58(2):130-41. No abstract available. French.

Reference Type BACKGROUND
PMID: 13532578 (View on PubMed)

Okumura A, Watanabe K. Clinico-electrical evolution in pre-hypsarrhythmic stage: towards prediction and prevention of West syndrome. Brain Dev. 2001 Nov;23(7):482-7. doi: 10.1016/s0387-7604(01)00291-1.

Reference Type BACKGROUND
PMID: 11701242 (View on PubMed)

Suzuki M, Okumura A, Watanabe K, Negoro T, Hayakawa F, Kato T, Itomi K, Kubota T, Maruyama K. The predictive value of electroencephalogram during early infancy for later development of West syndrome in infants with cystic periventricular leukomalacia. Epilepsia. 2003 Mar;44(3):443-6. doi: 10.1046/j.1528-1157.2003.29202.x.

Reference Type BACKGROUND
PMID: 12614401 (View on PubMed)

Philippi H, Wohlrab G, Bettendorf U, Borusiak P, Kluger G, Strobl K, Bast T. Electroencephalographic evolution of hypsarrhythmia: toward an early treatment option. Epilepsia. 2008 Nov;49(11):1859-64. doi: 10.1111/j.1528-1167.2008.01715.x. Epub 2008 Jul 9.

Reference Type BACKGROUND
PMID: 18631366 (View on PubMed)

Watanabe K, Iwase K, Hara K. The evolution of EEG features in infantile spasms: a prospective study. Dev Med Child Neurol. 1973 Oct;15(5):584-96. doi: 10.1111/j.1469-8749.1973.tb05169.x. No abstract available.

Reference Type BACKGROUND
PMID: 4358106 (View on PubMed)

Simon R. Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989 Mar;10(1):1-10. doi: 10.1016/0197-2456(89)90015-9.

Reference Type BACKGROUND
PMID: 2702835 (View on PubMed)

Related Links

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Other Identifiers

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2011-14518

Identifier Type: -

Identifier Source: org_study_id

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