Gerwe Martin, Stollhoff Kirsten, Mossakowski Jacek, Kuehle Hans-Juergen, Goertz Ulrich, Schaefer Christopher, Bogdanow Manuela, Heger Steffen
Medical and Scientific Affairs, Therapeutic Area Psychiatry/Neurology and Virologie, Janssen-Cilag GmbH, Johnson & Johnson Platz 1, 41470 Neuss, Germany.
Atten Defic Hyperact Disord. 2009 Dec;1(2):175-86. doi: 10.1007/s12402-009-0010-6. Epub 2009 Aug 6.
Attention-deficit/hyperactivity disorder may have substantial impact on family life, peer interactions, and quality of life. Stimulants are recommended as first-line pharmacotherapy for ADHD. OROS(®) MPH (Concerta(®)) is a long-acting preparation with duration of effect for up to 12 h. In this 8-week, prospective, open-label, non-interventional trial the impact of therapy with OROS(®) MPH on functioning in four different areas of life (school, recreation, family life, and peer interaction), severity of disease, and quality of life (QoL) as well as tolerability were investigated under daily routine care. 306 patients, aged 10.2±2.3 years, were either transitioned to OROS(®) MPH from short-acting, immediate-release MPH (-IR) preparations (n=231; 75%), or treatment was initiated with OROS(®) MPH in MPH-naïve patients (n =75; 25%). In both groups, therapy with OROS(®) MPH was associated with significant improvements in daily functioning, severity of disease, and QoL. Adverse events (AE) were documented in 160 patients (52.3%). In 95 patients (31.0%) a causal relationship was assessed as at least possible. Four serious AEs were reported in 2 patients and rated as doubtfully related to study medication. Most frequent AEs (≥5% of patients) were insomnia, anorexia, ineffectiveness of medication, and headache. In 12.1% of patients AE led to discontinuation of study participation. Considering the limitations of this non-interventional study, the results refer to the importance of a therapy that covers not only school-time, but also takes other areas of life into account. Initiating treatment with long-acting preparations, such as OROS(®) MPH in MPH-naïve patients might be a feasible option.
注意力缺陷/多动障碍可能对家庭生活、同伴互动和生活质量产生重大影响。兴奋剂被推荐作为治疗注意力缺陷多动障碍的一线药物疗法。OROS(®)MPH(康纳达(®))是一种长效制剂,作用持续时间长达12小时。在这项为期8周的前瞻性、开放标签、非干预性试验中,在日常常规护理下,研究了OROS(®)MPH治疗对生活四个不同领域(学校、娱乐、家庭生活和同伴互动)的功能、疾病严重程度、生活质量(QoL)以及耐受性的影响。306名年龄为10.2±2.3岁的患者,要么从短效速释MPH(-IR)制剂转换为OROS(®)MPH(n = 231;75%),要么在未使用过MPH的患者中开始使用OROS(®)MPH治疗(n = 75;25%)。在两组中,OROS(®)MPH治疗均与日常功能、疾病严重程度和生活质量的显著改善相关。160名患者(52.3%)记录了不良事件(AE)。在95名患者(31.0%)中,因果关系被评估为至少有可能。2名患者报告了4起严重不良事件,被评定为与研究药物的关系存疑。最常见的不良事件(≥5%的患者)是失眠、厌食、药物无效和头痛。12.1%的患者因不良事件而停止参与研究。考虑到这项非干预性研究的局限性,结果表明一种不仅涵盖上学时间,还考虑生活其他领域的治疗方法的重要性。在未使用过MPH的患者中开始使用长效制剂,如OROS(®)MPH,可能是一种可行的选择。