Laporan kasus berbasis bukti: Efektivitas Kortikosteroid dalam Pengobatan Spasme Infantil
Sari
Latar belakang. Spasme infantil (SI) adalah suatu sindrom epilepsi berat dengan awitan masa bayi. Hormon adrenokortikotropik(ACTH) merupakan obat utama pada SI. Karena ACTH tidak tersedia di Indonesia, kortikosteroid dipertimbangkan sebagai obat pengganti.
Tujuan. Telaah bukti membandingkan efektivitas kortikosteroid (prednison atau prednisolon) dan ACTH dalam mengobati SI.
Metode. Penelusuran literatur secara terstruktur pada pangkalan data Pubmed, Cohcrane dan Google Scholar.
Hasil. Didapatkan 19 artikel, dua artikel yang terpilih kemudian menjalani telaah kritis, terdiri dari satu meta-analisis dan satu meta-analisis network terhadap uji klinis acak terkontrol. Bukti yang tersedia menunjukkan bahwa kortikosteroid terutama prednisolon oral dosis tinggi (4 mg/kg/hari atau 40-60 mg/kg/hari) memiliki efektivitas setara dengan ACTH dalam menghentikan spasme atau menyebabkan perbaikan elektroensefalografi pada anak-anak dengan SI, meski tingkat kepastian bukti tergolong rendah.
Kesimpulan. Prednisolon oral dosis tinggi dapat digunakan untuk pengobatan SI apabila ACTH tidak tersedia.
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DOI: http://dx.doi.org/10.14238/sp23.6.2022.409-16
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