Abstract:
OBJECTIVE:Different methylphenidate (MPH) formulations, immediate release (IR) or extended release (ER), have been developed to treat Attention-Deficit/Hyperactivity Disorder (ADHD). A better use of these formulations, with a proper choice of their timing, dosage, and combination, can help to attain optimal therapeutic effect while maintaining a good quality of life. In this study, we aim at presenting a quantitative comparison approach to help identify drug regimens that provide best therapeutic performances and respect patients' specific needs. METHODS:Using pharmacokinetic (PK) models of various MPH formulations constructed with data in hand and a formerly developed performance metric for MPH regimens, we proposed a statistical integral strategy for regimen comparison, which comprises a sequential, a relative, and a probability-over-threshold method. The first is hierarchical in nature and sequentially compares the regimen performance, the total daily dose, and the administration frequency. The second compares two regimens by quantifying their similarity. The third computes the probability of an incremental regimen performance over a specified threshold. The first two comparison approaches are used for naive patients, whereas the third one is for patients under treatment. RESULTS:PK models of one compartment effectively describe both the IR and ER data. Applied to three frequent MPH clinical situations, the three-methods strategy is able to distinguish the regimens proposed for each. A combined regimen of IR and ER taken at the same time performs better than a single ER dose. CONCLUSION:The proposed statistical strategy is able to differentiate ADHD regimens in various clinically relevant situations, and adapt the use of MPH drugs to a patient's daily routine. Since it does not compare fixed doses and formulations but rather any MPH regimen, our approach generalizes the current context of bioequivalence study and provides an accessible computational tool for objectively selecting MPH regimens.
journal_name
J Child Adolesc Psychopharmacoljournal_title
Journal of child and adolescent psychopharmacologyauthors
Soufsaf S,Robaey P,Bonnefois G,Nekka F,Li Jdoi
10.1089/cap.2018.0093subject
Has Abstractpub_date
2019-04-01 00:00:00pages
220-234issue
3eissn
1044-5463issn
1557-8992journal_volume
29pub_type
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journal_title:Journal of child and adolescent psychopharmacology
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pub_type: 临床试验,杂志文章
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更新日期:2007-04-01 00:00:00
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doi:10.1089/cap.1992.2.279
更新日期:1992-01-01 00:00:00
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更新日期:2011-12-01 00:00:00
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doi:10.1089/cap.2008.033
更新日期:2008-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/cap.2005.15.693
更新日期:2005-08-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1089/cap.2011.0042
更新日期:2011-12-01 00:00:00
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更新日期:1996-01-01 00:00:00
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更新日期:2005-12-01 00:00:00
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更新日期:1999-01-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-05-01 00:00:00
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更新日期:2007-10-01 00:00:00
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更新日期:2006-02-01 00:00:00
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journal_title:Journal of child and adolescent psychopharmacology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-10-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-02-01 00:00:00