Evidence map›Paper›PMID 34862857›Full record

ArticleEpilepsia open2022

Adrenal function during long-term ACTH therapy for patients with developmental and epileptic encephalopathy.

Yuki Ueda, Shuta Fujishige, Takeru Goto, Shuhei Kimura, Noriko Namatame, Masashi Narugami, Sachiko Nakakubo, Midori Nakajima, Kiyoshi Egawa, Naoya Kaneko and 5 more

Open access · goldAbstract read
In one paragraph

Article in Epilepsia open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Yuki UedaDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.ORCID 0000-0002-6760-6766
Shuta FujishigeDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Takeru GotoDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Shuhei KimuraDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Noriko NamatameDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Masashi NarugamiDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Sachiko NakakuboDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Midori NakajimaDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Kiyoshi EgawaDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Naoya KanekoDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Kanako NakayamaDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Nozomi HishimuraDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Takeshi YamaguchiDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Akie NakamuraDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
Hideaki ShiraishiDepartment of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.ORCID 0000-0003-4199-0728
Hokkaido University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Some patients with developmental and epileptic encephalopathy (DEE) respond to adrenocorticotropic hormone (ACTH) therapy but relapse soon after. While long-term ACTH therapy (LT-ACTH) has been attempted for these patients, no previous studies have carefully assessed adrenal function during LT-ACTH. We evaluated the effectiveness of LT-ACTH, as well as adverse effects (AE), including their adrenal function in three DEE patients. Patients underwent a corticotropin-releasing hormone (CRH) stimulation test during LT-ACTH, and those with peak serum cortisol below 15 μg/dL were considered to be at high risk of adrenal insufficiency (AI). Two of three responded, and their life-threatening seizures with postgeneralized electroencephalogram (EEG) suppression decreased. Although no individuals had serious AE, CRH stimulation test revealed relatively weak responses, without reaching normal cortisol peak level (18 μg/dL). Hydrocortisone replacement during stress was prepared in a case with lower cortisol peak than our cutoff level. LT-ACTH could be a promising treatment option for cases of DEE that relapse soon after effective ACTH treatment. The longer duration and larger cumulative dosage in LT-ACTH than in conventional ACTH could increase the relative risk of AI. Careful evaluation with pediatric endocrinologists, including hormonal stimulation tests, might be useful for continuing this treatment safely.

Indexed as

Adrenal InsufficiencyBrain DiseasesAdrenocorticotropic HormoneChildCorticotropin-Releasing HormoneHumansHydrocortisoneAdrenocorticotropic HormoneCorticotropin-Releasing HormoneHydrocortisoneACTH therapyadrenal insufficiencydevelopmental and epileptic encephalopathylong-term treatment

Identifiers

PMID34862857
PMCPMC8886065
OpenAlexW3214879773

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.