Acthar and MS

Acthar delivers proven relief of MS relapses

Acthar effectively accelerates recovery based on improvements in patients' disability scores
In multiple head-to-head clinical studies, there were no demonstrated differences between the efficacy and safety of IV steroids and ACTH[3-5]

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 IVMP and intramuscular ACTH.[3] The IVMP group (n=29) received 1 gram daily for 3 days. The 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 IVMP. 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).[3]
§Compared therapeutic efficacy with dexamethasone and IVMP (n=10, ACTH; n=10, IVMP; n=10, dexamethasone). No significant difference was found between IVMP and ACTH at days 7 and 30.[4]
‡Compared clinical response to IVMP. No significant difference was found between the 2 groups at 3 months (n=11,ACTH; n=14, IVMP).[5]
The exact chemical form of ACTH used in these studies is unknown

Questcor

Indications for Use

H.P. Acthar^® Gel (repository corticotropin injection) is an adrenocorticotropic hormone (ACTH) analogue used for:

Monotherapy treatment of infantile spasms (IS) in infants and children under 2 years of age.
The treatment of exacerbations of multiple sclerosis in adults.
For inducing a diuresis or a remission of proteinuria in the nephrotic syndrome without uremia of the idiopathic type or that due to lupus erythematosus.
The following: rheumatic disorders; collagen diseases; dermatologic diseases; allergic states; ophthalmic diseases and respiratory diseases.

Important Safety Information

Acthar should never be given intravenously. It is contraindicated in patients with scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, recent surgery, history of or the presence of a peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction or sensitivity to proteins of porcine origin. Acthar is contraindicated in children under 2 years of age with suspected congenital infections. Administration of live or live attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of Acthar.

The adverse effects that may occur with Acthar are related primarily to its steroidogenic effects and are similar to corticosteroids. There may be increased susceptibility to new infection and increased risk of reactivation of latent infections. Adrenal insufficiency may occur after abrupt withdrawal of the drug following prolonged therapy. Cushing’s syndrome, elevated blood pressure, salt and water retention, and hypokalemia may be seen. Masking of symptoms of other underlying disease/disorders may occur. There is a risk of gastrointestinal perforation and bleeding with increased risk of perforation in patients with certain GI disorders. Onset or worsening of euphoria, insomnia, irritability (especially in infants), mood swings, personality changes, depression, and psychosis may occur. Caution should be used when prescribing Acthar to patients with diabetes or myasthenia gravis. Prolonged use may produce cataracts, ocular infections or glaucoma. Use in patients with hypothyroidism or liver cirrhosis may result in an enhanced effect. There may be negative effects on growth and physical development and decreases in bone density.

Specific adverse reactions reported in IS clinical trials in infants and children under 2 years of age included: infection, hypertension, irritability, Cushingoid symptoms, constipation, diarrhea, vomiting, pyrexia, weight gain, increased appetite, decreased appetite, nasal congestion, acne, rash, and cardiac hypertrophy. Convulsions were also reported, but these may actually be occurring because some IS patients progress to other forms of seizures and IS sometimes mask other seizures, which become visible once the clinical spasms from IS resolve.

Other adverse reactions in adults and children over 2 years of age included: abdominal distension, anxiety, asthma, chest discomfort, congestive heart failure, dizziness, dyspnea, erythema, fatigue, flushing, headache, hyperhidrosis, hypersensitivity or allergic reactions, injection site pain, muscle weakness, palpitations, peripheral edema, tachycardia, and weakness.

This is a summary only. For a full list of indications, contraindications, warnings, precautions, and adverse events related to Acthar, please refer to the full Prescribing Information.

H.P. Acthar^® Gel and Questcor^® are registered trademarks of Questcor Pharmaceuticals, Inc.

Download the Acthar Referral/Prescription Form

Prescribing Information

Acthar and MS

Acthar delivers proven relief of MS relapses

Questcor

Indications for Use

Important Safety Information