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Comment & Response |

Idiopathic Intracranial Hypertension—Reply

Michael Wall, MD1; Michael McDermott, PhD2; Mark Kupersmith, MD3
[+] Author Affiliations
1Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City
2University of Rochester School of Medicine and Dentistry, Rochester, New York
3Roosevelt Hospital, New York, New York
JAMA. 2014;312(10):1060. doi:10.1001/jama.2014.8903.
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In Reply We stand by our statement that there were no properly designed and executed clinical trials to guide therapy in IIH prior to ours. The results of the study by Ball et al1 were inconclusive with respect to efficacy due to the small sample size and consequent low power. The authors stated in their report that “This pilot study was not powered to detect a treatment effect.”1 Also, 12 of 25 patients in the acetazolamide group stopped taking medication, a discontinuation rate of nearly 50%. Dosing schedules for acetazolamide were at the discretion of the supervising clinician and did not get above 1500 mg/d. Twenty percent of the patients in the control group were eventually given acetazolamide. Therefore, this trial should not be used to guide therapy in IIH.

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April 23, 2014
The NORDIC Idiopathic Intracranial Hypertension Study Group Writing Committee
1University of Iowa, Iowa City
2University of Rochester School of Medicine & Dentistry, Rochester, New York
3University of Mississippi Medical Center, Jackson
4University of Rochester Eye Institute, Rochester, New York
5University of Texas Southwestern Medical Center, Dallas
6Bethesda Neurology LLC, Bethesda, Maryland
7University of California, Davis Medical Center
8National Eye Institute, Bethesda, Maryland
9Roosevelt Hospital, New York, New York
JAMA. 2014;311(16):1641-1651. doi:10.1001/jama.2014.3312.
September 10, 2014
Alex J. Sinclair, MBChB, PhD; Rebecca Woolley, BScHons; Susan P. Mollan, MBChB, FRCOphth
1Department of Neurotrauma and Neurodegeneration, University of Birmingham, Birmingham, England
2Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, England
3Birmingham Neuro-Ophthalmology Unit, University Hospitals Birmingham NHS Trust, Birmingham, England
JAMA. 2014;312(10):1059-1060. doi:10.1001/jama.2014.8894.
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