Table 6.
Adverse effects of ACTH
| Adverse effects | All |
Natural ACTH |
Synthetic ACTH |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Incidence rate | 95% CI | I2 | P-value | Incidence rate | 95% CI | I2 | P-value | Incidence rate | 95% CI | I2 | P-value | |
| Edema | 0.10 | 0.04–0.18 | 52 | 0.02 | 0.09 | 0.01–0.21 | 66 | 0.01 | 0.10 | 0.02–0.22 | 40 | 0.14 |
| Insomnia/increased alertness | 0.08 | 0.03–0.15 | 53 | 0.02 | 0.12 | 0.03–0.25 | 65 | 0.01 | 0.03 | 0.00–0.09 | 0 | 0.58 |
| Mood swings | 0.07 | 0.02–0.14 | 57 | 0.01 | 0.06 | 0.00–0.17 | 69 | 0.01 | 0.07 | 0.00–0.18 | 46 | 0.10 |
| Hyperglycemia | 0.07 | 0.04–0.11 | 0 | 0.52 | 0.10 | 0.05–0.16 | 0 | 0.52 | 0.04 | 0.00–0.09 | 0 | 0.59 |
| Hyperpigmentation | 0.06 | 0.02–0.12 | 44 | 0.05 | 0.06 | 0.02–0.12 | 12 | 0.34 | 0.06 | 0.00–0.18 | 64 | 0.02 |
| Hypertension | 0.06 | 0.02–0.11 | 36 | 0.11 | 0.05 | 0.01–0.11 | 25 | 0.24 | 0.06 | 0.00–0.17 | 51 | 0.07 |
| Weight gain | 0.06 | 0.03–0.11 | 26 | 0.19 | 0.10 | 0.04–0.18 | 26 | 0.24 | 0.03 | 0.00–0.07 | 0 | 0.64 |
| Gastrointestinal symptoms | 0.06 | 0.01–0.12 | 55 | 0.01 | 0.06 | 0.00–0.19 | 73 | <0.001 | 0.04 | 0.01–0.11 | 0 | 0.42 |
| Pain | 0.05 | 0.01–0.13 | 67 | <0.001 | 0.09 | 0.00–0.24 | 82 | <0.001 | 0.03 | 0.00–0.08 | 0 | 0.95 |
| Dizziness | 0.04 | 0.01–0.08 | 11 | 0.34 | 0.04 | 0.00–0.12 | 52 | 0.06 | 0.03 | 0.00–0.08 | 0 | 0.92 |
| Upper respiratory tract symptoms | 0.04 | 0.01–0.08 | 28 | 0.17 | 0.03 | 0.00–0.09 | 34 | 0.18 | 0.05 | 0.00–0.13 | 31 | 0.20 |
| Fatigue | 0.04 | 0.01–0.11 | 60 | <0.001 | 0.06 | 0.00–0.19 | 78 | <0.001 | 0.03 | 0.00–0.07 | 0 | 0.74 |
| Muscle cramps | 0.04 | 0.01–0.08 | 28 | 0.17 | 0.03 | 0.00–0.09 | 34 | 0.18 | 0.05 | 0.00–0.13 | 31 | 0.20 |
| Flushing | 0.03 | 0.01–0.06 | 0 | 0.83 | 0.04 | 0.01–0.09 | 9 | 0.36 | ||||
| Cushingoid appearance | 0.03 | 0.01–0.06 | 0 | 0.74 | 0.04 | 0.00–0.09 | 25 | 0.24 | ||||
| Rash | 0.03 | 0.01–0.06 | 0 | 0.86 | 0.02 | 0.00–0.06 | 0 | 0.69 | 0.04 | 0.00–0.10 | 0 | 0.72 |
| Respiratory tract infection | 0.02 | 0.01–0.05 | 0 | 0.99 | 0.02 | 0.00–0.05 | 0 | 0.94 | 0.03 | 0.00–0.08 | 0 | 0.89 |
| Bone loss | 0.02 | 0.00–0.04 | 0 | >0.99 | 0.02 | 0.00–0.05 | 0 | 0.92 | ||||
| Tremor | 0.02 | 0.01–0.05 | 0 | 0.83 | 0.03 | 0.00–0.07 | 18 | 0.30 | ||||
| Hoarseness | 0.02 | 0.00–0.05 | 0 | 0.97 | 0.02 | 0.00–0.06 | 0 | 0.60 | ||||
| Acne | 0.02 | 0.00–0.05 | 0 | >0.99 | 0.04 | 0.01–0.09 | 0 | 0.47 | ||||
| Blurred vision | 0.02 | 0.00–0.05 | 0 | 0.97 | 0.02 | 0.00–0.06 | 0 | 0.60 | ||||
| Polyuria | 0.02 | 0.01–0.05 | 0 | >0.99 | 0.02 | 0.00–0.05 | 0 | 0.94 | 0.03 | 0.00–0.08 | 0 | 0.95 |
| Palpitations | 0.02 | 0.01–0.05 | 0 | >0.99 | 0.02 | 0.00–0.05 | 0 | 0.94 | 0.03 | 0.00–0.08 | 0 | 0.95 |
| Increased appetite | 0.02 | 0.00–0.05 | 0 | >0.99 | 0.02 | 0.00–0.05 | 0 | 0.94 | ||||
| Delayed wound healing | 0.02 | 0.00–0.05 | 0 | >0.99 | 0.02 | 0.00–0.05 | 0 | 0.94 | ||||
ACTH, adrenocorticotropic hormone.