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

Adverse events
No significant differences were detected between
DEX and MPH treatments in the incidence of
headache, stomach ache, loss of appetite or
insomnia. Data on weight were not reported.
Summary
One study evaluated medium-dose MPH
compared with low-dose MPH. 50 This study
reported significant effects in favour of MPH when
hyperactivity was assessed by teachers, but not
when assessed by parents. They reported no
significant differences between treatments in the
incidence of headache, stomach ache, loss of
appetite or insomnia. Owing to the poor reporting
of some methodological criteria, the results from
this study should be interpreted with caution.
MPH medium dose (15–30 mg/day) versus DEX
medium dose (10–20 mg/day)
One study evaluated medium-dose
(15–30 mg/kg/day) immediate release IR-MPH
TABLE 55 MPH medium dose (15–30 mg/day) versus DEX medium dose (10–20 mg/day)
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Health Technology Assessment 2006; Vol. 10: No. 23
compared with medium-dose (10–20 mg/day)
DEX (Table 55; with additional information in
Appendix 12). In this crossover study by Arnold
and colleagues, 37 hyperactivity was assessed using
four scales. The authors reported no differences
between medium doses of MPH and DEX
(Table 56). This study did not report on CGI.
It generally scored well in the quality assessment.
Adverse events
Adverse event data were not reported adequately
to be included in the analysis.
Summary
The one study that evaluated medium-dose MPH
compared with medium-dose DEX reported no
difference in hyperactivity scores between the
treatment groups. 37 This study did not examine
CGI or adequately report on adverse events data.
It rated well in the quality assessment, hence
the results for hyperactivity are likely to be
reliable.
Study Design Intervention – N Age Duration Core outcomes
(years) (weeks)
Administered two or more times daily
Arnold, 1978 37 C (3×) MPH (1.25 mg/kg, 1 or 5–12 3 Core: Conners’ Teachers’
2×) vs DEX (0.63 mg/kg/day, Behaviour Problem Checklist:
1 or 2×) – 29 hyperactivity; Problem Behaviour
Checklist (parents): hyperactivity;
Davids’ Hyperkinetic Rating Scale
(parents and teachers)
QoL: not reported
AE: Problem Behaviour Checklist
(parents): side-effects; weight loss
C, Crossover trial (number of crossovers).
TABLE 56 Results for hyperactivity [MPH medium dose (15–30 mg/day) versus DEX medium dose (10–20 mg/day)]
Study Scale MPH medium dose: DEX medium p-Value (if
mean (SD) dose: mean (SD) reported)
5–12 years
Arnold, 1978 37 Problem Behaviour Checklist (parents) 18.21 (5.61) 17.21 (5.45) NR
(hyperactivity)
Conners’ Teachers’ Behaviour Problem 16.83 (5.50) 16.17 (4.64) NS
Checklist (hyperactivity)
Davids’ Hyperkinetic Rating Scale 4.31 (1.23) 4.28 (1.07) NS
(parents) (hyperactivity)
Davids’ Hyperkinetic Rating Scale 3.83 (1.49) 3.90 (1.54) NS
(teachers) (hyperactivity)
NR, not reported; NS, not significant.
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