Biederman Joseph, Quinn Declan, Weiss Margaret, Markabi Sabri, Weidenman Meredith, Edson Kathryn, Karlsson Goeril, Pohlmann Harald, Wigal Sharon
Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Paediatr Drugs. 2003;5(12):833-41. doi: 10.2165/00148581-200305120-00006.
To evaluate the safety and efficacy of extended-release methylphenidate with a bimodal profile using SODAS technology (Ritalin LA ) compared with placebo in children aged 6-14 years with attention deficit hyperactivity disorder (ADHD).
This was a multicenter, double-blind, randomized, placebo-controlled, parallel-group study in children meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for ADHD. Following titration and a 1-week placebo washout period, patients were randomized to 2 weeks of double-blind treatment with either Ritalin LA (10-40 mg/day) or placebo. The efficacy assessments used were the Conners' ADHD/DSM-IV Scales for teachers (CADS-T) and for parents (CADS-P), and the Clinical Global Impression-Improvement Scale (CGI-I) completed by the investigator. The primary efficacy variable was the change from baseline (end of placebo washout) to the final rating (end of 2-week double-blind treatment) in the CADS-T Total subscale score.
One-hundred-and-sixty-one children were treated and 134 responders were included in the intent-to-treat analysis. Ritalin LA achieved a mean change from baseline (+/- SD) on the CADS-T Total subscale of -10.7 (+/-15.68) compared with 2.8 (+/-10.59) for placebo (p < 0.0001); the effect size on the CADS-T Total score with Ritalin LA was 0.90. Additionally, 69.8% of patients in the Ritalin LA group were rated as much or very much improved on the CGI-I at final assessment compared with 40% of patients in the placebo group (p = 0.0009). The adverse events reported were generally mild or moderate, and were similar in both groups.
The results demonstrate that Ritalin LA administered once daily for up to 2 weeks achieved outcomes statistically superior to placebo in children with ADHD.
评估采用双峰释放技术的缓释哌甲酯(利他林长效型)与安慰剂相比,在6至14岁患有注意力缺陷多动障碍(ADHD)儿童中的安全性和有效性。
这是一项针对符合《精神疾病诊断与统计手册》(DSM-IV)中ADHD标准的儿童进行的多中心、双盲、随机、安慰剂对照、平行组研究。在滴定和为期1周的安慰剂洗脱期后,患者被随机分配接受为期2周的双盲治疗,治疗药物为利他林长效型(10 - 40毫克/天)或安慰剂。所采用的疗效评估指标包括教师用康纳斯ADHD/DSM-IV量表(CADS-T)、家长用康纳斯ADHD/DSM-IV量表(CADS-P)以及由研究者完成的临床总体印象改善量表(CGI-I)。主要疗效变量是CADS-T总分量表从基线(安慰剂洗脱期结束时)到最终评分(2周双盲治疗结束时)的变化。
161名儿童接受了治疗,134名有反应者纳入意向性分析。与安慰剂组在CADS-T总分量表上从基线的平均变化(±标准差)为2.8(±10.59)相比,利他林长效型的平均变化为-10.7(±15.68)(p < 0.0001);利他林长效型对CADS-T总分的效应量为0.90。此外,在最终评估时,利他林长效型组69.8%的患者在CGI-I上被评为改善很多或非常多,而安慰剂组为40%(p = 0.0009)。报告的不良事件一般为轻度或中度,两组相似。
结果表明,每日一次给予利他林长效型长达2周,在患有ADHD的儿童中取得了统计学上优于安慰剂的结果。