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APPENDICES. A systematic review and economic model of the ...

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Study Intervention Participants Outcomes<br />

Core symptoms<br />

ADHD Rating Scale total score<br />

CPRS-S (short form)<br />

ADHD Rating Scale subscales<br />

(inattentive; hyperactive/impulsive)<br />

References<br />

Spencer et al., 2002; 89<br />

Biederman et al.,<br />

2002 142<br />

Source<br />

Updated search<br />

Co-existent problems<br />

Not reported<br />

Arm 1<br />

ATX<br />

Maximum dose 2 mg/kg/day<br />

(90 mg/day) in two or three daily<br />

doses depending on prior<br />

psychostimulant exposure<br />

(Individuals administering medication<br />

not reported)<br />

Setting<br />

USA<br />

Educational performance<br />

Not reported<br />

Design<br />

Parallel trial<br />

Psychological function<br />

Not reported<br />

Inclusion criteria<br />

1. ADHD DSM-IV criteria<br />

2. Score on ADHD Rating Scale <strong>of</strong> >1.5 SD above age <strong>and</strong> gender<br />

norms for <strong>the</strong>ir diagnostic subtype (primarily inattentive or primarily<br />

hyperactive/impulsive) or <strong>the</strong> total score for <strong>the</strong> combined subtype<br />

3. No poor metabolisers <strong>of</strong> CYP2D6<br />

4. Weight >25 kg at study entry<br />

5. Normal intelligence on WISC<br />

6. Aged 7–13 years<br />

7. No documented history <strong>of</strong> bipolar I or II disorder or any history <strong>of</strong><br />

psychosis<br />

8. No history <strong>of</strong> organic brain disease or history <strong>of</strong> seizure disorder<br />

9. No psychotropic medication<br />

10. No history <strong>of</strong> alcohol or drug abuse within past 3 months <strong>and</strong> no<br />

significant prior or current medical conditions<br />

Arm 2<br />

Placebo<br />

(Individuals administering medication<br />

not reported)<br />

Depression or anxiety<br />

Not reported<br />

Quality <strong>of</strong> life<br />

CGI–ADHD, Severity<br />

Diagnostic criteria<br />

DSM-IV<br />

Duration<br />

12 weeks (2-week<br />

washout, 9 weeks <strong>of</strong><br />

treatment <strong>and</strong> 1-week<br />

drug discontinuation<br />

phase)<br />

Adverse events<br />

Unsolicited adverse events<br />

Number<br />

Total = 147<br />

Arm 1 = 65<br />

Arm 2 = 62<br />

© Queen’s Printer <strong>and</strong> Controller <strong>of</strong> HMSO 2006. All rights reserved.<br />

Additional outcomes<br />

Not reported<br />

Purpose<br />

To assess <strong>the</strong> safety <strong>and</strong><br />

efficacy <strong>of</strong> ATX<br />

compared with placebo<br />

in school-aged children<br />

with ADHD<br />

Health Technology Assessment 2006; Vol. 10: No. 23<br />

Total withdrawals = 25<br />

Arm 1 = 16<br />

Arm 2 = 9<br />

(For both trials: 89 ATX n = 129, placebo n = 124)<br />

Males: ATX n = 98, placebo n = 103<br />

Females: ATX n = 31, placebo n = 21<br />

Reasons for withdrawals:<br />

The most common reason for discontinuation was lack <strong>of</strong> efficacy<br />

R<strong>and</strong>omisation procedure:<br />

Patients were stratified according to prior exposure to psychostimulants.<br />

20 patients with no prior exposure to psychostimulants were<br />

r<strong>and</strong>omised to MPH. MPH treatment was included to validate study<br />

design in <strong>the</strong> event that ATX failed to separate from placebo. MPH<br />

results not reported<br />

continued<br />

337

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