Open AccessPredictors of pharmacological treatment outcomes with atomoxetine or methylphenidate in patients with attention‐deficit/hyperactivity disorder from China, Egypt, Lebanon, Russian Federation, Taiwan, and United Arab Emirates
Author(s) -
Treuer T.,
Feng Q.,
Desaiah D.,
Altin M.,
Wu S.,
ElShafei A.,
Serebryakova E.,
Gado M.,
Faries D.
Publication year - 2014
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12437
Subject(s) - atomoxetine , medicine , methylphenidate , attention deficit hyperactivity disorder , logistic regression , atomoxetine hydrochloride , psychiatry , proportional hazards model , cohort , pediatrics , demography , sociology
Summary Background The reduced availability of data from non‐Western countries limits our ability to understand attention‐deficit/hyperactivity disorder ( ADHD ) treatment outcomes, specifically, adherence and persistence of ADHD in children and adolescents. This analysis assessed predictors of treatment outcomes in a non‐Western cohort of patients with ADHD treated with atomoxetine or methylphenidate. Methods Data from a 12‐month, prospective, observational study in outpatients aged 6–17 years treated with atomoxetine ( N = 234) or methylphenidate ( N = 221) were analysed post hoc to determine potential predictors of treatment outcomes. Participating countries included the Russian Federation, China, Taiwan, Egypt, United Arab Emirates and Lebanon. Factors associated with remission were analysed with stepwise multiple logistic regression and classification and regression trees (CART). Cox proportional hazards models with propensity score adjustment assessed differences in atomoxetine persistence among initial‐dose cohorts. Results In patients treated with atomoxetine who had available dosing information ( N = 134), Cox proportional hazards revealed lower (< 0.5 mg/kg) initial dose was significantly associated with shorter medication persistence (p < 0.01). multiple logistic regression analysis revealed greater rates of remission for atomoxetine‐treated patients were associated with age (older), country (United Arab Emirates) and gender (female) (all p < 0.05). CART analysis confirmed older age and lack of specific phobias were associated with greater remission rates. For methylphenidate, greater baseline weight (highly correlated with the age factor found for atomoxetine) and prior atomoxetine use were associated with greater remission rates. Conclusions These findings may help clinicians assess factors upon initiation of ADHD treatment to improve course prediction, proper dosing and treatment adherence and persistence. Trial registration Observational study, therefore no registration.