Wigal Sharon B, Wilens Timothy E, Wolraich Mark, Lerner Marc
Department of Pediatrics, University of California, Irvine, CA 92612, USA.
Pediatrics. 2007 Jul;120(1):e120-8. doi: 10.1542/peds.2006-1402. Epub 2007 Jun 4.
Patients receiving methylphenidate for the management of attention-deficit/hyperactivity disorder are recommended to receive periodic hematologic monitoring. The objective of this study was to evaluate the long-term effects of methylphenidate treatment on blood biochemistry and hematologic values.
This study involved a detailed analysis of changes in hematologic and blood biochemistry values over the course of a 2-year study of once-daily OROS methylphenidate in otherwise healthy children aged 6 to 13 years with attention-deficit/hyperactivity disorder. Routine hematologic and blood biochemistry assessments were performed at baseline, at 6 and 12 months during study treatment, and at the end of the study.
Of the 407 subjects enrolled in the study, 289 completed year 1, and 229 completed 21 of 24 months. No subject was excluded from entry into the study or discontinued from the study because of abnormalities of any of the blood chemistries evaluated. There were no clinically significant changes from baseline in mean values for hematologic or blood biochemistry parameters. For most values, the mean change in value over the course of the study was <5%.
These longer-term data suggest that chronic therapy with OROS methylphenidate has no clinically significant impact on laboratory values, challenging the necessity of routine hematologic monitoring in otherwise healthy children with attention-deficit/hyperactivity disorder who are treated with methylphenidate.
建议接受哌甲酯治疗注意力缺陷/多动障碍的患者定期进行血液学监测。本研究的目的是评估哌甲酯治疗对血液生化和血液学指标的长期影响。
本研究对6至13岁患有注意力缺陷/多动障碍的健康儿童进行了为期2年的每日一次OROS哌甲酯研究,详细分析了血液学和血液生化指标的变化。在基线、研究治疗期间的6个月和12个月以及研究结束时进行常规血液学和血液生化评估。
在纳入研究的407名受试者中,289名完成了第1年的研究,229名完成了24个月中的21个月。没有受试者因所评估的任何血液化学指标异常而被排除在研究之外或退出研究。血液学或血液生化参数的平均值与基线相比没有临床显著变化。对于大多数指标,研究过程中的平均变化值<5%。
这些长期数据表明,OROS哌甲酯的长期治疗对实验室指标没有临床显著影响,这对接受哌甲酯治疗的健康注意力缺陷/多动障碍儿童进行常规血液学监测的必要性提出了挑战。