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在实验室教室环境中,对患有注意力缺陷/多动障碍的儿童进行的一项关于利他林长效制剂(Ritalin® LA)疗效和安全性的双盲、随机、安慰剂/活性对照交叉评估。

A double-blind, randomized, placebo/active controlled crossover evaluation of the efficacy and safety of Ritalin ® LA in children with attention-deficit/hyperactivity disorder in a laboratory classroom setting.

作者信息

Schulz Eberhard, Fleischhaker Christian, Hennighausen Klaus, Heiser Philip, Oehler Klaus-Uwe, Linder Martin, Haessler Frank, Huss Michael, Warnke Andreas, Schmidt Martin, Schulte-Markworth Michael, Sieder Christian, Klatt Jan, Tracik Ferenc

机构信息

Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany.

出版信息

J Child Adolesc Psychopharmacol. 2010 Oct;20(5):377-85. doi: 10.1089/cap.2009.0106.

Abstract

OBJECTIVES

The primary objective of this study was to demonstrate efficacy of Ritalin(®) LA 20 mg by showing superiority to placebo and noninferiority to Medikinet(®) Retard in a laboratory classroom setting. Secondary objectives included safety/tolerability and further efficacy parameters.

METHODS

A total of 147 children with attention-deficit/hyperactivity disorder (ADHD) diagnosed by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and aged 6-14 (81% males) and known to be methylphenidate (MPH) responders were enrolled in this multicenter, double-blind, randomized, placebo/active-controlled, three-period (7 days each) crossover study. The Swanson, Kotlin, Agler, M-Flynn, and Pelham (SKAMP) scale was used for efficacy ratings. The mean of SKAMP Combined ratings performed at 10:30 a.m., at 12:00 a.m., and at 1:30 p.m. was defined as the primary parameter.

RESULTS

In all, 146 patients completed all treatment periods. Intensity and frequency of adverse events were comparable between the two formulations. Ritalin(®) LA demonstrated superiority compared to placebo (p<0.0001). The observed difference in the SKAMP scores between Ritalin(®) LA and Medikinet(®) Retard between the hours 1.5 until 4.5 did not exceed the noninferiority margin (p=0.0003); therefore, the difference is regarded as not clinically relevant. Similar results were obtained for the secondary efficacy variables.

CONCLUSION

Ritalin(®) LA is an efficacious, well-tolerated treatment option for children aged 6-14 with ADHD.

摘要

目的

本研究的主要目的是在实验室课堂环境中,通过显示优于安慰剂以及不劣于美达力新(Medikinet)缓释片,来证明20毫克长效利他林(Ritalin)LA的疗效。次要目标包括安全性/耐受性以及其他疗效参数。

方法

总共147名患有注意力缺陷多动障碍(ADHD)的儿童被纳入这项多中心、双盲、随机、安慰剂/活性对照、三阶段(各7天)交叉研究。这些儿童根据儿童情感障碍和精神分裂症量表(K-SADS)被诊断为患有ADHD,年龄在6至14岁之间(81%为男性),并且已知是哌甲酯(MPH)反应者。使用斯旺森、科特林、阿格勒、M-弗林和佩勒姆(SKAMP)量表进行疗效评级。将上午10:30、中午12:00和下午1:30进行的SKAMP综合评分的平均值定义为主要参数。

结果

共有146名患者完成了所有治疗阶段。两种制剂之间不良事件的强度和频率相当。长效利他林(Ritalin)LA显示出优于安慰剂(p<0.0001)。在1.5小时至4.5小时之间,长效利他林(Ritalin)LA和美达力新(Medikinet)缓释片之间观察到的SKAMP评分差异未超过非劣效界值(p=0.0003);因此,该差异被认为不具有临床相关性。次要疗效变量也获得了类似结果。

结论

长效利他林(Ritalin)LA是治疗6至14岁ADHD儿童的一种有效且耐受性良好的治疗选择。

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