On the CGI-I scale , the analysis revealed that MPH was more effective than ATX and GXR .
For any adverse events , RBX ( 89 % ) was the safest alternative .
Network meta- analysis offered a broader overview on the available treatments for ADHD , especially for safety issues , and contributes towards evidence gathering and clinical practice decisions .
The aim of this study is to gather evidence of head-to-head double-blind r and omized-controlled trials on the efficacy and safety of available treatments for attention deficit hyperactivity disorder ( ADHD ) in children and adolescents .
A randomized trial of edivoxetine in pediatric patients with attention-deficit/hyperactivity disorder.
OBJECTIVE The purpose of this study was to assess the efficacy and safety of edivoxetine ( LY2216684 ) , a selective norepinephrine reuptake inhibitor , in pediatric patients with attention-deficit/hyperactivity disorder ( ADHD ) . METHOD A fixed-dose , r and omized , double-blind , 8 week study was conducted in patients 6 - 17 years of age , who were r and omized by two strata : 1 ) Patients with prior stimulant use r and omized to placebo , edivoxetine 0.1 mg/kg/day , 0.2 mg/kg/day , or 0.3 mg/kg/day arms in a 1:1:1:1 ratio ; 2 ) Stimulant-naïve patients r and omized to placebo , edivoxetine 0.1mg/kg/day , 0.2 mg/kg/day , 0.3 mg/kg/day , or osmotic-release oral system methylpheni date ( OROS MPH ) ( 18 - 54 mg/day based on body weight ) arms in a 1:1:1:1:1 ratio . The primary efficacy measure was baseline-to-week 8 change of ADHD Rating Scale ( ADHD-RS ) total score for edivoxetine 0.2 mg/kg/day and 0.3 mg/kg/day . RESULTS A total of 340 patients were r and omized to placebo ( n=78 ) ; edivoxetine 0.1 mg/kg/day ( n=76 ) , 0.2 mg/kg/day ( n=75 ) , or 0.3 mg/kg/day ( n=75 ) ; or OROS MPH ( n=36 ) . In the stimulant-naïve stratum , the positive control , OROS MPH , was significantly superior to placebo in mean ADHD-RS total score change at end-point ( -19.46 , p=0.015 ) . The edivoxetine 0.2 mg/kg/day and 0.3 mg/kg/day arms had statistically significantly greater improvement than the placebo arm in mean ADHD-RS total score change at end-point ( placebo -10.35 ; edivoxetine 0.2 mg/kg/day -16.09 , p<0.010 ; edivoxetine 0.3 mg/kg/day -16.39 , p<0.010 ) and Clinical Global Impressions-Improvement score  ( placebo 3.05 ; edivoxetine 0.1 mg/kg/day 3.01 , p=0.860 ; edivoxetine 0.2 mg/kg/day 2.54 , p=0.013 ; edivoxetine 0.3 mg/kg/day 2.53 , p=0.013 ) . In the overall efficacy-analyses data set ( n=270 ) , the effect size estimates for edivoxetine doses 0.1 mg/kg/day , 0.2 mg/kg/day and 0.3 mg/kg/day at the week 8 time point were 0.17 , 0.51 , and 0.54 , respectively ( for the stimulant-naïve stratum , the effect size estimate for OROS MPH was 0.69 ) . Compared with placebo , edivoxetine treatment was associated with statistically significant increases in blood pressure and pulse ( p<0.050 ) , and a smaller increase or slight decrease in weight .  CONCLUSIONS Edivoxetine at doses of 0.2 mg/kg/day and 0.3 mg/kg/day demonstrated efficacy in ADHD treatment , despite the presence of a sizeable placebo response . No unexpected adverse events were identified . Clinical Trial Registry identifier : NCT00922636
On the CGI-I scale , the analysis revealed that MPH was more effective than ATX and GXR .
For any adverse events , RBX ( 89 % ) was the safest alternative .
Network meta- analysis offered a broader overview on the available treatments for ADHD , especially for safety issues , and contributes towards evidence gathering and clinical practice decisions .
The aim of this study is to gather evidence of head-to-head double-blind r and omized-controlled trials on the efficacy and safety of available treatments for attention deficit hyperactivity disorder ( ADHD ) in children and adolescents .