PDF herunterladen
Open Access
CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(08): s00451811173
DOI: 10.1055/s-0045-1811173
Review Article

Corticotherapy versus adrenocorticotropic hormone for treating West syndrome: a systematic review and meta-analysis

Authors


Funding This study was funded by a PIBIC (Institutional Program of Scientific Initiation Scholarships) scholarship granted by the National Council for Scientific and Technological Development (CNPq) in partnership with the Federal University of Roraima (UFRR).
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints
Preview

Abstract

Background

Although it is known that the most commonly used therapies for West syndrome (WS) are intramuscular adrenocorticotropic hormone (ACTH) and oral prednisolone, there is still controversy in the literature regarding the equivalence of their effects.

Objective

We aimed to present an updated review comparing the therapeutic and adverse effects of ACTH therapy versus corticosteroids in children with West syndrome (WS).

Methods

The PubMed, EMBASE, and Cochrane Central databases were searched. The outcomes of interest selected were spasm cessation on day 14 of therapy, cessation of hypsarrhythmia and adverse effects such as weight gain, infection, irritability, and hypertension. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and a meta-analysis was performed. We compared the results using the risk ratio (RR) and odds ratio (OR). for the binary outcomes, with 95% confidence intervals (CI) and a random-effects model. Statistical analysis was performed using RevMan 5.1.7.

Results

Compared with corticoids, ACTH was associated with a significant increase in weight (RR: 1.41; 95% CI: 1.01–1.97; p = 0.04). There was no significant difference in cessation of spasms on day 14 (OR: 0.91; 95% CI: 0.47–1.47; p = 0.79), hypsarrhythmia (OR: 0.97; 95% CI: 0.22–4.34), irritability (RR: 0.78; 95% CI: 0.30–1.99), hypertension (RR: 0.64; 95% CI: 0.35–1.15; p = 0.14), and infection (RR: 0.69; 95% CI: 0.19–2.50; p = 0.57).

Conclusion

This study provides robust evidence regarding the safety and efficacy of ACTH or corticoids in children with WS. However, the significant heterogeneity between studies restricts the analysis, emphasizing the need for additional research to assess the best WS treatment option.

Keywords

Spasms, Infantile - Epilepsy - Adrenocorticotropic Hormone - Adrenal Cortex Hormones

Author's Contributions

Conceptualization: EHF, KDAS, GSR, GSN; Data curation: AK, JCAMS; Formal analysis: AMPS, APMN, AK, NPB; Investigation: NPB; Methodology: EHF, AMPS, KDAS, APMN; Project administration: KDAS, GSR, GSN; Supervision: GSR, GSN; Validation: EHF, AMPS; Visualization: EHF, KDAS, NPB; Writing - original draft: EHF, AMPS, KDAS, APMN, AK, JCAMS; Writing - review & editing: EHF, AMPS, KDAS, APMN, AK, JCAMS, GSR, GSN.


Data Availability Statement

Extracted study data available by request to authors.


Editor-in-Chief: Hélio A. G. Teive ORCID is 0000-0003-2305-1073.


Associate Editor: Aline Chacon Pereira ORCID is. 0000-0002-2287-4038.




Publikationsverlauf

Eingereicht: 04. Februar 2025

Angenommen: 27. Mai 2025

Artikel online veröffentlicht:
31. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Elizabeth Honorato de Farias, Anderson Matheus Pereira da Silva, Karlos Daniell Araújo dos Santos, Altair Pereira de Melo Neto, Aishwarya Koppanatham, Júlia Cappi Aguiar Moraes Souza, Niels Pacheco-Barrios, Gabrielle de Souza Rocha, Gustavo Sousa Noleto. Corticotherapy versus adrenocorticotropic hormone for treating West syndrome: a systematic review and meta-analysis. Arq Neuropsiquiatr 2025; 83: s00451811173.
DOI: 10.1055/s-0045-1811173