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FDA-approved medicines exist for specific indications

ACTH 1-39

Full-length corticotropin (1–39) — labeled RCI/Acthar carefully; ≠ cosyntropin 1–24; ≠ gray-market.

Editorial review:
What evidence says

Evidence snapshot

This drawer marks papers. It is not a plan, a dose, or a source. A paper is a bounded report. It is not a protocol. Grades name the object. They are not a safety rating.

Identity lock. ACTH 1-39 is full-length adrenocorticotropic hormone / corticotropin (39 amino acids). PubChem CID 16132265 (corticotropin / Acthar-class records); formula C207H308N56O58S / MW ~4541; CAS 9002-60-2 (among historical CAS listings). Labeled repository corticotropin injection (RCI / Acthar Gel) is a regulated biologic object in some jurisdictions for selected inflammatory / autoimmune / infantile-spasms narratives — not the same as gray-market “ACTH peptide” talk. ≠ tetracosactide / cosyntropin (ACTH 1-24) PubChem CID 16129617. ≠ Semax / Adamax (ACTH-fragment analogues — separate drawers). This drawer marks papers. It is not use advice.

Bottom line

Evidence for the labeled repository corticotropin object is dominated by clinical-use narratives, historical autoimmune/inflammatory series, MS and nephrotic-syndrome practice literature, and infantile-spasms / Acthar Gel program papers. That labeled object must stay separated from unregulated peptide-vial claims. Cosyntropin (1-24) diagnostic/stimulation use is a different molecule.

Papers

Labeled repository corticotropin (Acthar / RCI) — clinical narratives

PMID 37397803 — Wan 2023

Tested: narrative literature review of clinical and economic evidence for Acthar Gel (repository corticotropin injection).

Does not show: that every autoimmune claim is proven in a modern pivotal RCT, or that unlabeled ACTH vials equal RCI.

PMID 37792273 — Kaplan 2023

Tested: historical perspective and characterization of clinical evidence for Acthar Gel across autoimmune/inflammatory disease uses.

Does not show: a single new Phase 3 for every listed use; secondary synthesis.

PMID 40952620 — Mirsaeidi 2025

Tested: narrative review of immunomodulatory effects of Acthar Gel beyond steroidogenic properties.

Does not show: that non-steroidogenic mechanisms replace controlled efficacy endpoints.

PMID 27433309 — Kutz 2016

Tested: repository corticotropin injection treatment framing in patients with multiple sclerosis and diabetes (clinical series/context).

Does not show: a large confirmatory MS disease-modification RCT vs modern standards as the sole grade.

PMID 32576069 — Chugani 2020

Tested: prospective study of neuroinflammation markers in children with infantile spasms before and after Acthar Gel (repository corticotropin).

Does not show: interchangeability with cosyntropin 1-24 or gray-market ACTH 1-39.

Related object — animal spasms model (not human grade)

PMID 33548914 — Le 2021

Tested: Acthar Gel dose-response relationships in an animal model of epileptic spasms.

Does not show: a human dosing protocol or consumer use advice.

What is not established

Equivalence of gray-market “ACTH” vials to labeled repository corticotropin injection. That ACTH 1-39 papers grade cosyntropin (1-24) or Semax/Adamax. Modern confirmatory RCTs for every historical autoimmune use listed in narrative reviews. This drawer does not provide use advice, schedules, or sourcing.

Selected sources

37397803 37792273 40952620 27433309 32576069 33548914

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