| Title |
Guanfacine extended release for children and adolescents with attention-deficit/hyperactivity disorder: efficacy following prior methylphenidate treatment
|
|---|---|
| Published in |
Neuropsychiatric Disease and Treatment, May 2016
|
| DOI | 10.2147/ndt.s94158 |
| Pubmed ID | |
| Authors |
Katharine Murkett, Vanja Sikirica, Amaia Hervás, Jeffrey Newcorn, Valerie Harpin, Brigitte Robertson, Michael Huss |
| Abstract |
Guanfacine extended release (GXR) and atomoxetine (ATX) are nonstimulant treatments for attention-deficit/hyperactivity disorder (ADHD). As nonstimulant treatments are often used after stimulants in ADHD, GXR was assessed relative to prior stimulant treatment in a randomized controlled trial (RCT), in which ATX was included as a reference arm, and in the open-label phase of a randomized-withdrawal study (RWS). Participants were 6-17 years old with ADHD Rating Scale version IV (ADHD-RS-IV) scores ≥32 and Clinical Global Impressions - Severity scores ≥4. RCT participants received dose-optimized GXR (1-7 mg/day), ATX (10-100 mg/day), or placebo for 10-13 weeks. RWS participants received dose-optimized GXR (1-7 mg/day) for 13 weeks. Participants' last stimulant medication prior to enrolment, and reasons for stopping this medication, were collected at baseline. Change from baseline ADHD-RS-IV score and the proportion of responders were assessed by prior stimulant exposure. Of 163 RCT and 296 RWS participants who had previously received stimulant treatment, 142 and 224, respectively, had received methylphenidate (MPH); due to the low number of participants and the heterogeneity of non-MPH treatments, we only report data for prior MPH treatment. The most frequent reasons for stopping MPH were lack of effectiveness or side effects. Placebo-adjusted ADHD-RS-IV changes from baseline were significant in participants receiving GXR (prior MPH, -9.8, P<0.001, effect size [ES] 0.85; stimulant-naïve, -7.6, P<0.001, ES 0.65). In ATX-treated participants, significant placebo-adjusted differences were seen in stimulant-naïve (-5.0, P=0.022, ES 0.43) but not prior MPH-treated (-1.8, P>0.05, ES 0.15) participants. More participants met responder criteria with GXR versus placebo, regardless of prior treatment. GXR response was unaffected by prior stimulant treatment; ATX produced improvement only in stimulant-naïve participants relative to placebo. These findings may be relevant to clinical decision-making regarding sequencing of ADHD treatments. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 67% |
| Members of the public | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 56 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 13 | 23% |
| Student > Master | 11 | 20% |
| Student > Ph. D. Student | 5 | 9% |
| Professor | 3 | 5% |
| Student > Bachelor | 3 | 5% |
| Other | 11 | 20% |
| Unknown | 10 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 34% |
| Psychology | 14 | 25% |
| Engineering | 3 | 5% |
| Neuroscience | 3 | 5% |
| Social Sciences | 2 | 4% |
| Other | 3 | 5% |
| Unknown | 12 | 21% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 May 2016.
All research outputs
#16,737,737
of 25,394,764 outputs
Outputs from Neuropsychiatric Disease and Treatment
#1,719
of 3,131 outputs
Outputs of similar age
#181,706
of 311,961 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#64
of 99 outputs
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