Comparative efficacy and safety of attention-deficit/hyperactivity disorder pharmacotherapies, including guanfacine extended release: a mixed treatment comparison.
This study compared the clinical efficacy and safety of attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy in children and adolescents 6-17 years of age. A systematic literature review was conducted to identify randomized controlled trials (RCTs) of pharmacologic monotherapies among chi...
| Publicado en: | European Child & Adolescent Psychiatry Vol. 26; no. 8; pp. 875 - 898 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2017
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124332431&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124332431 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10188827 EJ3 jtl: European Child & Adolescent Psychiatry issn: 10188827 maglogo: N pubinfo: dt: Aug2017 vid: 26 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 124332431 124332431 144057627 124332431 10.1007/s00787-017-0962-6 124332431 ppf: 875 ppct: 23 formats: fmt: @attributes: type: P tig: atl: Comparative efficacy and safety of attention-deficit/hyperactivity disorder pharmacotherapies, including guanfacine extended release: a mixed treatment comparison. aug: au: Joseph, Alain Ayyagari, Rajeev Xie, Meng Cai, Sean Xie, Jipan Huss, Michael Sikirica, Vanja affil: Shire , Zug Switzerland sug: subj: Attention Deficit Hyperactivity Disorder Drug Therapy Psychiatric Care Treatment Outcomes Systematic Review Meta Analysis Human Medline Embase Psycinfo Cochrane Library CINAHL Database Randomized Controlled Trials Psychiatric Patients Child Adolescence Attention Deficit Hyperactivity Disorder Symptoms Adrenergic alpha-Agonists Therapeutic Use Adrenergic Uptake Inhibitors Therapeutic Use Central Nervous System Stimulants Therapeutic Use Psychological Tests Scales Severity of Illness Indices Child: 6-12 years Adolescent: 13-18 years ab: This study compared the clinical efficacy and safety of attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy in children and adolescents 6-17 years of age. A systematic literature review was conducted to identify randomized controlled trials (RCTs) of pharmacologic monotherapies among children and adolescents with ADHD. A Bayesian network meta-analysis was conducted to compare change in symptoms using the ADHD Rating Scale Version IV (ADHD-RS-IV), Clinical Global Impression-Improvement (CGI-I) response, all-cause discontinuation, and adverse event-related discontinuation. Thirty-six RCTs were included in the analysis. The mean (95% credible interval [CrI]) ADHD-RS-IV total score change from baseline (active minus placebo) was −14.98 (−17.14, −12.80) for lisdexamfetamine dimesylate (LDX), −9.33 (−11.63, −7.04) for methylphenidate (MPH) extended release, −8.68 (−10.63, −6.72) for guanfacine extended release (GXR), and −6.88 (−8.22, −5.49) for atomoxetine (ATX); data were unavailable for MPH immediate release. The relative risk (95% CrI) for CGI-I response (active versus placebo) was 2.56 (2.21, 2.91) for LDX, 2.13 (1.70, 2.54) for MPH extended release, 1.94 (1.59, 2.29) for GXR, 1.77 (1.31, 2.26) for ATX, and 1.62 (1.05, 2.17) for MPH immediate release. Among non-stimulant pharmacotherapies, GXR was more effective than ATX when comparing ADHD-RS-IV total score change (with a posterior probability of 93.91%) and CGI-I response (posterior probability 76.13%). This study found that LDX had greater efficacy than GXR, ATX, and MPH in the treatment of children and adolescents with ADHD. GXR had a high posterior probability of being more efficacious than ATX, although their CrIs overlapped. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|