Table 3 Treatment with oral steroids: Short-term treatment

Ref.nClassType of steroid (dose)Duration of full dose, wkTotal treatment duration, wkOther Rx
* The study by Baram et al.16 is considered a class I when comparing ACTH vs prednisone but class III study when considering whether either medication was effective in decreasing the number of infantile spasms because it did not contain a placebo-controlled group.
† Results prior to crossover (phase I).
‡ Short-term outcome at 10 mo.
Rx = treatment; F/U = follow-up; SIS = symptomatic infantile spasms; CIS = cryptogenic infantile spasms; RH = reversal of hypsarrhythmia; NS = not stated; ACTH = adrenocorticotropic hormone; HPT = hypertension; CN = completely normal.
1614I/III*Prednisone (2 mg/kg)24No
15ACTH (150 IU/m2)24No
1712IIPrednisone (2 mg/kg)VariableVariableNo
12ACTH (20 IU/m2)67No
23IIIPrednisolone (2 mg/kg)820–32NS
CIS38Prednisolone (2 mg/kg)820–32NS
SIS39Prednisolone (2 mg/kg)820–32NS
3012IIIPrednisone (2 mg/kg)620NS
2822IVPrednisone (3 mg/kg)416NS
Mean F/U, moCessation of spasms, no. (%)SIS vs CIS, no. (%)Resolution of hypsarrhythmia, no. (%)Relapse, no. (%)Side effects, no. (%)Time to improved
16.94 (29)3 (30) vs 1 (25)4 (29) RHNSNil ceased Rx1 wk
1513 (87)(92) vs (67)13 (87) RH(15)Nil ceased Rx1 wk
NS4 (33)NS4 (33) RH2 (29)HPT 6 (25), 10 (63) atrophy33% w/in 2/52
NS5 (42)NS5 (42) RH(33)75% w/in 2/52
10HPT (10)NS
1015 (39)16 (42) CNNSNS
1014 (36)11 (28) CNNSNS
NS3 (25)NS3 (25)0 (0)NSNS
4713 (59)NS11 (50) CN8 (62)NSMean 7 d