Treatment of infantile spasms.
Shaun A Hussain
https://pubmed.ncbi.nlm.nih.gov/30564773/Actively Recruiting
Led by University of California, Los Angeles · Updated on 2025-05-08
40
Participants Needed
1
Research Sites
17 weeks
Total Duration
Researchers are investigating how to prevent relapse in infants with Infantile Epileptic Spasms Syndrome IESS who have responded to standard treatment. This study aims to find out if low-dose prednisolone is safe, well tolerated, and can reduce the risk of relapse, which is linked to poor long-term outcomes like autism and other types of epilepsy. The study is a Phase 2 randomized clinical trial with a quadruple-blind design conducted by the University of California, Los Angeles. Participants will be randomly assigned to receive either low-dose prednisolone with famotidine or matching placebos for 4 months. During the first 7 months, patients will have monthly clinic visits including electroencephalography EEG to monitor their condition. After this period, they will have a final evaluation at age 2 years to assess relapse, development of other seizures, and behavioral outcomes. The study also evaluates the feasibility of the treatment and study procedures. Throughout the trial, infants will be closely monitored for any treatment-related side effects and for relapse of epileptic spasms. Researchers will assess developmental and behavioral status at age 2 years and track the incidence of autism spectrum disorder. Safety is monitored from enrollment through the 5-month visit, and participants are followed until their last evaluation at age 2 years. Total participation lasts until the child reaches 2 years of age, with regular visits and assessments to ensure careful observation.
CONDITIONS
A Study to Prevent Infantile Spasms Relapse
S
Shaun A. Hussain, MD, MS
A
Angela L. Martinez
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University of California, Los Angeles
Lead Sponsor
Pediatric Epilepsy Research Foundation
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Prednisolone maintenance | Placebo | Current standard care |
|---|---|---|---|
| What is it? | Extended low-dose prednisolone given for several weeks after documented remission of infantile spasms to attempt prevention of relapse, sometimes with famotidine for GI protection. | Placebo administered for an identical period in infants who have responded to initial spasms therapy, sometimes with famotidine to match GI protection. | Standard care after resolved infantile spasms is the discontinuation of corticosteroid treatment with no maintenance steroid therapy, as recommended by guidelines. |
| Role in study | Investigational relapse-prevention therapy under randomized assignment; part of factorial study arms. | Control group matching the investigational arm with visually identical placebo; assigned by randomization. | Represents usual care after spasm resolution: discontinuation of steroids, no maintenance therapy, ongoing monitoring. |
| Primary use | Intended to reduce the risk of relapse of infantile spasms after achieving initial remission. | Serves as inactive comparator; not expected to affect relapse risk but controls for placebo effect. | Routine practice is discontinuing corticosteroids once spasms have resolved and EEG confirms response, without further steroids to reduce relapse. |
| How is it given? | Low-dose prednisolone tablets given orally for a defined period following EEG-confirmed remission, sometimes with famotidine for stomach protection as per factorial trial assignment. | Matching, visually identical oral placebo administered for the same period, with or without famotidine per factorial assignment. | No corticosteroid administered after initial spasms treatment is complete and response confirmed; no maintenance medicine is given. |
| Evidence status | Current evidence for maintenance prednisolone is limited; ongoing trials like this study are testing whether it prevents relapse after initial remission. | Placebo does not provide active therapy and is used to assess effectiveness of maintenance prednisolone. | Discontinuing corticosteroids after spasms resolve is the standard, with moderate evidence that further maintenance therapy does not improve long-term outcomes. |
| Important limitations | Long-term safety of maintenance corticosteroid use in this setting is not yet established. Potential side effects include increased infection risk, hypertension, or metabolic changes. | Placebo has no therapeutic effect. As a control, does not offer potential relapse prevention. | There remains a risk of relapse with standard care, and no established additional intervention to reduce this risk after initial spasm control exists yet. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 4 months
Participants receive either low-dose prednisolone and famotidine or placebo for 4 months.
Monthly clinic visits with electroencephalography (EEG) for 4 months
Duration - Up to approximately 19 months after treatment
Participants are evaluated monthly for 7 months to monitor for infantile spasms relapse, emergence of other seizures, and developmental/behavioral status, with a final evaluation at age 2 years.
Monthly visits for 7 months after treatment and 1 final visit at age 2 years
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
FACTORIAL
Primary Purpose
PREVENTION
Number of Arms
2
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Shaun A Hussain
https://pubmed.ncbi.nlm.nih.gov/30564773/University of California, Los Angeles
Lead Sponsor
Pediatric Epilepsy Research Foundation
Collaborating Sponsor