Journal of the American Academy of Child & Adolescent Psychiatry
New researchEfficacy and Safety of Atomoxetine in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: Results From a Comprehensive Meta-Analysis and Metaregression
Section snippets
Materials and Methods
We conducted an electronic search, using MEDLINE/PubMed, www.clinicaltrialsresults.com, www.clinicaltrials.gov, and www.lillytrials.com for all published and unpublished, acute DBRCTs and for meta-analyses of ATX published until August 2012. Studies had to be published in English. Search terms included: (ADHD OR Attention-Deficit Hyperactivity OR Deficit/Hyperactivity OR Attention Deficit-Hyperactivity OR Attention Deficit Hyperactivity) AND (Atomoxetine OR ATX OR Strattera) AND (random*). Hand
Search
The search identified 374 potentially eligible sources, consisting of 245 references in PubMed, 68 trials in clinicaltrials.gov, and 61 trials in clinicaltrialresults.com or lillytrials.com. At the title/abstract level, 253 sources could be excluded. Of the remaining 121 references another 70 sources were excluded after full text review. The remaining 51 data sources were included in this review (29 from PubMed, 17 from clinicaltrials.gov, and 5 from clinicaltrialresults.com or lillytrials.com
Discussion
This largest and most comprehensive meta-analysis including 3,928 pediatric patients found ATX to be superior to placebo for ADHD on a number of relevant outcomes. Efficacy advantages compared to placebo included the following: significantly greater decreases in total, inattentive, and hyperactive parent-rated and total teacher-rated ADHD symptom scores with medium ESs of −0.59 to −0.67; greater response rates with a NNT of 4 using study-defined response criteria as well as ≥25% and ≥40%
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Cited by (0)
This article is discussed in and editorial by Dr. Michael H. Bloch on page 135.
Clinical guidance is available at the end of this article.
Dr. Correll served as the statistical expert for this research.
Disclosure: Dr. Correll has received grant or research support from the National Institute of Mental Health (NIMH), Bristol-Myers Squibb/Otsuka, the Feinstein Institute for Medical Research, Janssen/Johnson and Johnson, and the National Alliance for Research in Schizophrenia and Depression. He has served as a consultant to Actelion, Alexza Pharmaceuticals, the American Academy of Child and Adolescent Psychiatry, AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Co., Genentech, the Gerson Lehrman Group, IntraCellular Therapies, Lundbeck, Medavante, Medscape, Merck, NIMH, Janssen/Johnson and Johnson, Otsuka, Pfizer, ProPhase, Roche, Sunovion, Takeda, Teva, and Vanda. He has served on the speakers' bureau of Merck (nonpromotional lectures only). He owns stock in Alexza Pharmaceuticals. He has participated in continuing medical education (CME) article preparation for Medscape. He is a member of the Data Safety Monitoring Boards for Cephalon, Janssen/Johnson and Johnson, Lundbeck, Pfizer, Takeda, and Teva. Dr. Schwartz reports no biomedical financial interests or potential conflicts of interest.