Long-Acting Methylphenidate Formulations for ADHD
Long-Acting Methylphenidate Formulations for ADHD
A literature search was conducted using the MEDLINE (1950–Present) and PsycINFO (1806–Present) databases to identify head-to-head studies of long-acting MPH formulations. The final search was conducted on 21 March 2012 and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for methodology. The following search terms were developed, refined and tested for relevance by cross-checking results against a list of known relevant articles: MeSH terms: attention deficit disorder with hyperactivity/drug therapy; methylphenidate/therapeutic use; All Fields: Concerta; Ritalin LA; OROS and ADHD; Medikinet; Equasym XL and ADHD; long-acting methylphenidate; Diffucaps and ADHD; SODAS and methylphenidate. In addition, searches for Biphentin and ADHD, methylphenidate transdermal system and ADHD, and Metadate CD and ADHD were performed following the final search to corroborate findings (no additional studies were identified that met the search criteria). No filters were used during the search as key references were missed during the development and testing of the search strategy when filters were applied. No language, publication date or publication status limitations were imposed. All search results were combined into a single master database and duplicates removed. References within the master database were then screened by title for the following keywords to identify articles of possible relevance: methylphenidate; Concerta; Ritalin LA; OROS; Medikinet; Equasym XL; Diffucaps; SODAS; Spheroidal Oral Drug Absorption System; extended-release; extended release; long-acting; long acting; modified-release; modified release; single-dose; single dose; once-daily; once daily; methylphenidate transdermal system; MTS; osmotic-release; osmotic release; laboratory; meta-analysis; once-a-day; once a day. Articles were selected if the title indicated a comparison of two or more long-acting methylphenidate preparations in humans; articles with ambiguous titles were selected for further screening by abstract and/or full text. Studies involving subjects of any age with ADHD of any subtype receiving long-acting MPH were considered. Study diagnostic criteria and inclusion criteria were not assessed during the screening process. Both switching studies and observational studies were included; however, non-systematic review articles and non-peer-reviewed data were not included in this review. Articles selected by title screening were then assessed independently for eligibility by a second person; potentially eligible articles were then screened by abstract and disagreement regarding eligibility was resolved through discussion. If the suitability of an article was unclear, the full-text article was assessed. Reference lists of relevant systematic reviews and meta-analyses were cross-referenced against identified articles. Data extraction, performed independently by two people, included article category, drug and dosing, age group, sample size, diagnosis, inclusion/exclusion criteria, comorbid conditions, outcome measures, main findings and conclusions. Possible sources of bias were identified as multiple reports from single studies and variability in outcome measures and parameters among studies. Meta-analysis was not feasible owing to the heterogeneity in outcomes reported across all study types included in the review; however, a systematic approach was applied to identify comparisons of interest and synthesize the findings of multiple studies.
Methods
A literature search was conducted using the MEDLINE (1950–Present) and PsycINFO (1806–Present) databases to identify head-to-head studies of long-acting MPH formulations. The final search was conducted on 21 March 2012 and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for methodology. The following search terms were developed, refined and tested for relevance by cross-checking results against a list of known relevant articles: MeSH terms: attention deficit disorder with hyperactivity/drug therapy; methylphenidate/therapeutic use; All Fields: Concerta; Ritalin LA; OROS and ADHD; Medikinet; Equasym XL and ADHD; long-acting methylphenidate; Diffucaps and ADHD; SODAS and methylphenidate. In addition, searches for Biphentin and ADHD, methylphenidate transdermal system and ADHD, and Metadate CD and ADHD were performed following the final search to corroborate findings (no additional studies were identified that met the search criteria). No filters were used during the search as key references were missed during the development and testing of the search strategy when filters were applied. No language, publication date or publication status limitations were imposed. All search results were combined into a single master database and duplicates removed. References within the master database were then screened by title for the following keywords to identify articles of possible relevance: methylphenidate; Concerta; Ritalin LA; OROS; Medikinet; Equasym XL; Diffucaps; SODAS; Spheroidal Oral Drug Absorption System; extended-release; extended release; long-acting; long acting; modified-release; modified release; single-dose; single dose; once-daily; once daily; methylphenidate transdermal system; MTS; osmotic-release; osmotic release; laboratory; meta-analysis; once-a-day; once a day. Articles were selected if the title indicated a comparison of two or more long-acting methylphenidate preparations in humans; articles with ambiguous titles were selected for further screening by abstract and/or full text. Studies involving subjects of any age with ADHD of any subtype receiving long-acting MPH were considered. Study diagnostic criteria and inclusion criteria were not assessed during the screening process. Both switching studies and observational studies were included; however, non-systematic review articles and non-peer-reviewed data were not included in this review. Articles selected by title screening were then assessed independently for eligibility by a second person; potentially eligible articles were then screened by abstract and disagreement regarding eligibility was resolved through discussion. If the suitability of an article was unclear, the full-text article was assessed. Reference lists of relevant systematic reviews and meta-analyses were cross-referenced against identified articles. Data extraction, performed independently by two people, included article category, drug and dosing, age group, sample size, diagnosis, inclusion/exclusion criteria, comorbid conditions, outcome measures, main findings and conclusions. Possible sources of bias were identified as multiple reports from single studies and variability in outcome measures and parameters among studies. Meta-analysis was not feasible owing to the heterogeneity in outcomes reported across all study types included in the review; however, a systematic approach was applied to identify comparisons of interest and synthesize the findings of multiple studies.
