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Cited by 38Attention Deficit Hyperactivity DisorderPharmaceutical studies and practicesBehavioral and Psychological Studies

Comparative efficacy and safety of attention-deficit/hyperactivity disorder pharmacotherapies, including guanfacine extended release: a mixed treatment comparison

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Joseph, Alain, Ayyagari, Rajeev, Xie, Meng, Cai, Sean, Xie, Jipan, Huss, Michael, Sikirica, Vanja·2017·European Child & Adolescent Psychiatry
DOI 10.1007/s00787-017-0962-6PMC PMC5532417
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Abstract

This study compared the clinical efficacy and safety of attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy in children and adolescents 6-17 years of age. A systematic literature review was conducted to identify randomized controlled trials (RCTs) of pharmacologic monotherapies among children and adolescents with ADHD. A Bayesian network meta-analysis was conducted to compare change in symptoms using the ADHD Rating Scale Version IV (ADHD-RS-IV), Clinical Global Impression-Improvement (CGI-I) response, all-cause discontinuation, and adverse event-related discontinuation. Thirty-six RCTs were included in the analysis. The mean (95% credible interval [CrI]) ADHD-RS-IV total score change from baseline (active minus placebo) was -14.98 (-17.14, -12.80) for lisdexamfetamine dimesylate (LDX), -9.33 (-11.63, -7.04) for methylphenidate (MPH) extended release, -8.68 (-10.63, -6.72) for guanfacine extended release (GXR), and -6.88 (-8.22, -5.49) for atomoxetine (ATX); data were unavailable for MPH immediate release. The relative risk (95% CrI) for CGI-I response (active versus placebo) was 2.56 (2.21, 2.91) for LDX, 2.13 (1.70, 2.54) for MPH extended release, 1.94 (1.59, 2.29) for GXR, 1.77 (1.31, 2.26) for ATX, and 1.62 (1.05, 2.17) for MPH immediate release. Among non-stimulant pharmacotherapies, GXR was more effective than ATX when comparing ADHD-RS-IV total score change (with a posterior probability of 93.91%) and CGI-I response (posterior probability 76.13%). This study found that LDX had greater efficacy than GXR, ATX, and MPH in the treatment of children and adolescents with ADHD. GXR had a high posterior probability of being more efficacious than ATX, although their CrIs overlapped.

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Cited by

Sorted by citations

Authors
Joseph, A., Ayyagari, R., Xie, M., Cai, S., Xie, J., Huss, M., & Sikirica, V.
Affiliations
  • Shire (Switzerland) (CH)
  • Analysis Group (United States) (US)
  • Takeda (United States) (US)
Corresponding author
Ayyagari, Rajeev
ORCID
Venue
European Child & Adolescent Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2017-03-03
Volume
26
Issue
8
Pages
875-897
ISSN
  • 1018-8827 (ISSN-L)
  • 1435-165X
DOI
10.1007/s00787-017-0962-6
PMC
PMC5532417
OpenAlex
W2591851413
Cited by
38
References
8
Citations by year
2026: 3 · 2025: 6 · 2024: 1 · 2023: 3 · 2022: 7 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 9 · 2017: 2
FWCI
0.62
Type
journal article
Language
en
Open access
Licence
Locations
  • European Child & Adolescent Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Shire Development, LLC
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords
attention deficit hyperactivity disorder, ADHD medication, guanfacine extended release, lisdexamfetamine dimesylate, atomoxetine, non-stimulant medication, stimulant medication, treatment efficacy, treatment safety, adverse events, children and adolescents, ADHD Rating Scale-IV, CGI-I
MeSH terms
Adolescent, Antihypertensive Agents, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Guanfacine

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