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达索西汀治疗注意缺陷/多动障碍患者的安全性和有效性:一项纳入1594例患者的系统评价和荟萃分析,包括GRADE分级。

Safety and efficacy of dasotraline for patients with attention deficit/hyperactivity disorder: a systematic review and meta-analysis of 1594 patients including GRADE qualifications.

作者信息

Mansour Mohamed Ezzat M, Alsaadany Khalid Radwan, Ahmed Mohamed Awad E, Elmetwalli Ahmed Ezzat

机构信息

Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA.

出版信息

Psychopharmacology (Berl). 2025 Jan;242(1):45-62. doi: 10.1007/s00213-024-06723-5. Epub 2024 Dec 19.

Abstract

INTRODUCTION

Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder. It is one of the most common mental disorders in youth worldwide characterized by persistent overactivity and impulsivity/inattention symptoms associated with social and academic impairment. dasotraline has been suggested to play a pivotal role as a serotonin, norepinephrine, and dopamine reuptake inhibitor. This study aimed to create evidence from published randomized clinical trials (RCTs) about the benefits of dasotraline for ADHD patients.

METHODS

A computer literature search (PubMed, Scopus, Web of Science, and Cochrane CENTRAL) was conducted. We included RCTs comparing dasotraline versus placebo. The primary outcome measure was the ADHD Rating Scale-IV score, pooled as the mean difference between the two groups from baseline to the endpoint. The secondary outcome measures were the ADHD Rating Scale-IV Inattention score, ADHD Rating Scale-IV Hyperactivity score.

RESULTS

Five RCTs with a total of 1594 patients were included in this study. dasotraline showed a significant improvement in the primary outcome (MD -2.65, 95% CI [-4.14 to -1.17], P= 0.0004 CONCLUSION: The results showed that dasotraline demonstrated a significant improvement in both primary and secondary outcomes, establishing its efficacy as a novel treatment for ADHD symptoms. However, mild to moderate side effects were observed.

摘要

引言

注意力缺陷多动障碍(ADHD)是一种复杂的神经发育障碍。它是全球青少年中最常见的精神障碍之一,其特征是持续存在多动以及与社交和学业受损相关的冲动/注意力不集中症状。达索西汀被认为作为一种血清素、去甲肾上腺素和多巴胺再摄取抑制剂发挥着关键作用。本研究旨在从已发表的随机临床试验(RCT)中获取关于达索西汀对ADHD患者益处的证据。

方法

进行了计算机文献检索(PubMed、Scopus、科学网和Cochrane中心对照试验注册库)。我们纳入了比较达索西汀与安慰剂的随机对照试验。主要结局指标是ADHD评定量表第四版(ADHD Rating Scale-IV)评分,汇总为两组从基线到终点的平均差异。次要结局指标是ADHD评定量表第四版注意力不集中评分、ADHD评定量表第四版多动评分。

结果

本研究纳入了5项随机对照试验,共1594例患者。达索西汀在主要结局方面显示出显著改善(平均差 -2.65,95%置信区间[-4.14至-1.17],P = 0.0004)。结论:结果表明,达索西汀在主要和次要结局方面均显示出显著改善,确立了其作为ADHD症状新型治疗方法的疗效。然而,观察到了轻度至中度的副作用。

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