In an RCT,2232 children with IESS were evaluated receiving either low (0.1 mg) or high (0.25 mg) intramuscular ACTH dose once a day for 1 week, then weekly decreasing to once every other day, twice a week, once a week, and once every 2 weeks until 8 weeks of treatment. This evidence concerns the gene POMC and infantile spasms.