POMC and Epileptic encephalopathy: Infantile spasms (IS) is a frequently devastating form of epileptic encephalopathy that usually presents in the first year of life with epileptic spasms, hypsarrhythmia (including variations thereof), and neurodevelopmental arrest.1 Unsuccessful treatment is linked to adverse long‐term developmental outcomes.2 There is relatively broad consensus that the most effective first‐line therapies for IS are vigabatrin and an array of hormonal therapies,3, 4 including oral corticosteroids and intramuscular adrenocorticotropic hormone (ACTH).