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A Randomized Prospective Trial Comparing Repository Corticotropin Injection and Intravenous Methylprednisolone for
Jeffrey L Bennett1, Nathan C Grove, Ruth K Johnson
1Departments of Neurology (JLB, RJ, CM) and Ophthalmology (JLB, NG, AML), University of Colorado School of Medicine, Aurora, Colorado; Programs in Neuroscience and Immunology (JLB), University of Colorado School of Medicine, Aurora, Colorado; Department of Ophthalmology (JD, KSS), Scheie Eye Institute, FM Kirby Center for Molecular Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics and Informatics (BDW), University of Colorado School of Public Health, Aurora, Colorado; and Department of Neurology (TCF, EMF), Medical University of South Carolina, Charleston, South Carolina.
Repository corticotrophin injection and intravenous methylprednisolone showed similar outcomes for acute optic neuritis treatment. Neither therapy demonstrated a significant difference in visual recovery or optic nerve structure preservation.
Area of Science:
- Ophthalmology
- Neuroscience
- Immunology
Background:
- Acute optic neuritis is an inflammatory condition affecting vision.
- Repository corticotrophin injection (RCI) and intravenous methylprednisolone (IVMP) are treatments for optic neuritis.
- RCI possesses unique properties potentially offering distinct anti-inflammatory benefits.
Purpose of the Study:
- To compare the efficacy of RCI and IVMP in treating acute optic neuritis.
- To evaluate the impact of these treatments on visual recovery and optic nerve structure.
- To assess patient-reported outcomes including visual function, mood, and quality of life.
Main Methods:
- Prospective randomized controlled trial comparing RCI and IVMP in acute optic neuritis patients.
- Serial evaluation of peripapillary retinal nerve fiber layer (pRNFL) and GC+IPL thickness using OCT.
- Measurement of visual acuity, fatigue, mood, depression, and quality of life.
Main Results:
- No significant difference in pRNFL thickness loss at 6 months between RCI and IVMP groups.
- Similar 6-month attenuation of GC+IPL thickness and frequency of pRNFL swelling in both treatment arms.
- Both RCI and IVMP led to improvements in visual function and patient-reported outcomes.
Conclusions:
- RCI and IVMP demonstrate comparable clinical effectiveness in managing acute optic neuritis.
- No clinically meaningful differences were observed in optic nerve structure or visual function recovery.
- Both treatments offer benefits in visual function and patient-reported outcomes for acute optic neuritis.
