Efficacy in Acute Exacerbations of Multiple Sclerosis

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

  • Accelerates recovery from acute MS exacerbations[1][2]
  • In multiple head-to-head clinical studies, there were no demonstrated differences between the efficacy and safety of intravenous methylprednisolone (IVMP) and ACTH[2][3][4][5]
  • Approved by the FDA since 1978 and has a well-established side effect profile[1]
Acthar Efficacy

*Results from a double-blind, randomized, controlled study investigating disability outcome (Kurtzke Disability Status Scale) in patients with acute MS relapse before, during, and after treatment with IV methylprednisolone (IVMP) and intramuscular ACTH. IV methylprednisolone group (n=29) received 1 gram daily for 3 days. ACTH group (n=32) received 80 units daily for 7 days, 40 units daily for 4 days, and 20 units daily for 3 days.

Acthar vs. Steroids

† Compared efficacy with IV methylprednisolone. No demonstrated difference was found between the 2 groups in either the rate of recovery or in the final outcome for acute relapse at 12 weeks (n=32, ACTH; n=29, IVMP).

‡ Compared clinical response to IV methylprednisolone. No significant difference was found between the 2 groups at 3 months (n=11, ACTH; n=14, IVMP).

§ Compared the therapeutic efficacy with dexamethasone and IV methylprednisolone (n=10, ACTH; n=10, IVMP; n=10, dexamethasone). No significant difference was found between IV methylprednisolone and ACTH at days 7 and 30.

References

  1. ^ H.P. Acthar® Gel (repository corticotropin injection), prescribing information, Questcor Pharmaceuticals, Inc.
  2. ^ Thompson AJ, Kennard C, Swash M, et al. Relative efficacy of intravenous methylprednisolone and ACTH in the treatment of acute relapse in MS. Neurology. 1989;39:969-971.
  3. ^ Filippini G, Brusaferri F, Sibley WA, et al. Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. Cochrane Database of Syst Rev. 2000;(4):CD001331.
  4. ^ Milanese C, La Mantia L, Salmaggi A, et al. Double-blind randomized trial of ACTH versus dexamethasone versus methylprednisolone in multiple sclerosis bouts. Eur Neurol. 1989;29:10-14.
  5. ^ Barnes MP, Bateman DE, Cleland PG, et al. Intravenous methylprednisolone for multiple sclerosis in relapse. J Neurol Neurosurg Psychiatry. 1985;48:157-159.