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. 2018 May 10;2018(5):CD012069. doi: 10.1002/14651858.CD012069.pub2

Haertling 2015.

Methods A prospective, multicentre, observational cohort study of long‐acting methylphenidate use for 12 weeks
Participants Number of participants screened: not stated
Number of participants included: 262
Number of participants followed up: not stated
Number of withdrawals: 23
Diagnosis of ADHD: ICD‐10 (subtype: combined (58%), hyperactive‐impulsive (34%), inattentive (8%))
Age: mean 10.9 (SD 2.5) years old (range: 11‐18)
IQ: not stated
Sex: 197 males, 63 females, 2 unknown
Methylphenidate‐naïve: 19.1%
Ethnicity: not stated
Country: Germany
Comorbidity: not stated
Comedication: not stated
Sociodemographics: not stated
 Inclusion criteria
  1. Definite ADHD diagnosis (DSM‐IV criteria)

  2. ADHD symptoms for ≥ 6 months having caused clinically significant impairment in ≥ 2 settings

  3. Informed consent by parents and patients

  4. Age: 11‐18 years

  5. Sufficient ability to read, write, communicate and understand the study procedures


Exclusion criteria
  1. Contraindications for methylphenidate

Interventions Methylphenidate type: long‐acting methylphenidate
Methylphenidate dosage: start with 20 mg once daily and to adjust in weekly 10 mg increments to a maximum of 60 mg/day
Administration schedule: once in the morning
Duration of intervention: 12 weeks
Treatment compliance: not stated
Outcomes Measure method/instrument: AEs according to the Medical Dictionary for Regulatory Activities (MedDRA), version 13
 A total of 63 AEs were reported in 36 (13.7%) patients. Severity was mild in 30.2%, moderate in 39.7%, and severe in 22.2% of AEs; 7.9% of data were missing. 28 patients had AEs believed to be treatment related (10.7%). By the end of the study, more than half of the AEs had resolved completely
The most frequent AEs were loss of appetite, abdominal pain, and nausea. The most frequently affected System Organ Classes were metabolism and nutritional as well as psychiatric and nervous system disorders
The number of AE per patient sums up to 4 adverse reactions in 1 patient throughout the whole treatment course
(50.79% of all AEs) the outcome was 'resolved'. In 20 AE‐cases (31.75%) the outcome was 'not yet resolved'. In 1 patient the outcome of the AE was not known
Serious adverse events
3 (hospitalisation) (0.4% of patients)
Non‐serious adverse events:
60
Notes Sample calculation: not stated
Ethics approval: ethics committee approval
Funding/vested interest: this study was initiated and sponsored by Novartis Pharma Germany. B Mueller is a full‐time employee of Novartis Pharma GmbH, the market authorisation holder of Ritalin LA. F Haertling received honorariums during the participation of this study. O Bilke‐Hentsch received honorariums as principle investigator of this study
 Authors' affiliations: Novartis Pharma
Key conclusions of the study authors: Ritalin LA improved CGI and quality of life in children with ADHD under routine practice conditions
Exclusion of methylphenidate non‐responders/children who have previously experienced adverse events on methylphenidate: not stated; however, children with poor response to previous treatment plans are included
 Supplemental information regarding IQ, comedication, comorbidity and additional AE tables requested through personal email correspondence with the authors in June 2016 (Mueller 2016 [pers comm]). The authors were not able to supply the information