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ACTH (adrenocorticotropic hormone) for multiple sclerosis

Healthwise
By Shannon Erstad, MBA/MPH

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Examples

Brand Name Chemical Name
ACTH, Acthar, Cortrosyn corticotropin

How It Works

Corticotropin is a man-made (synthetic) form of adrenocorticotropic hormone, or ACTH. Corticotropin can relieve symptoms during multiple sclerosis (MS) attacks by stimulating the body to produce and release corticosteroids that naturally reduce inflammation.

This medication is injected into the muscle or beneath the skin.

Why It Is Used

ACTH may be used to treat sudden, severe (acute) MS attacks. During an attack, you may need a shot every day for 2 to 3 weeks.

ACTH is rarely used today because of the severe allergic reactions it can cause. Synthetic corticosteroids, such as methylprednisolone, are considered the medications of choice for treating acute attacks since they rarely cause allergic reactions.

How Well It Works

When an acute MS attack occurs, high doses of ACTH may shorten the attack and help you recover more quickly.1 ACTH does not stop the progression of MS, but it does help reduce symptoms during an attack.

Side Effects

Side effects of ACTH may include:

  • Retention of fluids.
  • Muscle weakness.
  • High blood pressure.
  • Menstrual irregularities.
  • Lowered resistance to infections.
  • Allergic reactions.
  • Agitation.
  • Impaired sleep.
  • Delirium (confusion).

Long-term use of ACTH can result in more serious side effects that may not go away.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

ACTH is not used for long-term treatment of MS because it does not prevent the progression of the disease.

Corticosteroids such as methylprednisolone are often used instead of ACTH. Although no studies have directly compared the results of treatment with corticosteroids and treatment with ACTH, corticosteroids seem to act more quickly and have fewer side effects.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Bogglid M, Ford H (2004). Multiple sclerosis. Clinical Evidence (12): 1841–1858.

Credits

Author Shannon Erstad, MBA/MPH
Editor Kathleen M. Ariss, MS
Associate Editor Michele Cronen
Associate Editor Pat Truman
Primary Medical Reviewer Kathleen Romito, MD
- Family Medicine
Specialist Medical Reviewer Barrie J. Hurwitz, MD
- Neurology
Last Updated March 23, 2006
Author:Shannon Erstad, MBA/MPH
Last Updated: 03/23/2006