Predictors of relapse or maintenance of response in pediatric and adult patients with attention-deficit/hyperactivity disorder following discontinuation of long-term treatment with atomoxetine

• Verfasst von: Thome, Johannes [VerfasserIn]
• Verfasst von: Dittmann, Ralf [VerfasserIn]
• Titel: Predictors of relapse or maintenance of response in pediatric and adult patients with attention-deficit/hyperactivity disorder following discontinuation of long-term treatment with atomoxetine
• Verf.angabe: Johannes Thome, Ralf W. Dittmann, Laurence L. Greenhill, Sarah Lipsius, Yoko Tanaka, Chris Bushe, Rodrigo Escobar, Alexandra N. Heinloth, Himanshu Upadhyaya
• E-Jahr: 2017
• Jahr: 5 May 2017
• Umfang: 11 S.
• Fussnoten: Gesehen am 03.05.2018
• Titel Quelle: Enthalten in: ADHD Attention Deficit and Hyperactivity Disorders
• Ort Quelle: Wien [u.a.] : Springer, 2009
• Jahr Quelle: 2017
• Band/Heft Quelle: 9(2017), 4, Seite 219-229
• ISSN Quelle: 1866-6647
• DOI: doi:10.1007/s12402-017-0227-8
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1572589612

Abstract

We identified relapse/maintenance-of-response (MOR) predictors following discontinuation of long-term atomoxetine treatment in pediatric and adult patients with attention-deficit/hyperactivity disorder (ADHD) and assessed correlations between ADHD symptoms and quality of life (QoL). Post hoc analyses of data from two randomized, double-blind, placebo-controlled, phase 3 withdrawal studies in patients with ADHD meeting predefined response criteria before randomization. Study 1: patients (N = 163; 6-15 years) received atomoxetine (1.2-1.8 mg/kg/day) for 1 year, followed by randomization to atomoxetine (n = 81) or placebo (n = 82) for 6 months. Study 2: patients (N = 524; 18-50 years) received atomoxetine (80-100 mg/day) for ~6 months, followed by randomization to atomoxetine (n = 266) or placebo (n = 258) for ~6 months. Placebo patients were used for the analyses. Relapse: ≥50% worsening of prerandomization improvement in ADHD symptoms and ≥2 level severity increase on the Clinical Global Impression-Severity (CGI-S) scale at 2 consecutive visits; MOR: retaining ≥75% of prerandomization symptom improvement and CGI-S ≤ 2 at all visits (study 1); retaining ≥70% of prerandomization symptom improvement and CGI-S ≤ 3 at all visits (study 2). In adults, statistically significantly (P ≤ .05) increased likelihood of relapse was associated with prerandomization presence of Conners’ Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator-Rated:Screening Version (CAARS-Inv:SV) items “difficulty awaiting turn” and “careless mistakes.” In pediatric patients, less MOR was associated with prerandomization presence of ADHD Rating Scale-IV-Parent Version Investigator-Rated item “does not listen”; in adults, less MOR was associated with prerandomization presence of CAARS-Inv:SV items “loses things” and “difficulty awaiting turn.” Changes in patients’ QoL after withdrawal from atomoxetine moderately correlated with changes in ADHD symptoms in pediatric patients and mildly in adults.