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J Child Adolesc Psychopharmacol. 2017 Aug;27(6):474-482. doi: 10.1089/cap.2017.0084. Epub 2017 Jul 21.

Efficacy and Safety of HLD200, Delayed-Release and Extended-Release Methylphenidate, in Children with Attention-Deficit/Hyperactivity Disorder.

Author information

1
1 The University of Texas Health Science Center at San Antonio , San Antonio, Texas.
2
2 Massachusetts General Hospital , Boston, Massachusetts.
3
3 Westside Medical Family Practice , Clinton, Utah.
4
4 University of Tennessee Health Science Center , Memphis, Tennessee.
5
5 Meridien Research , Maitland, Florida.
6
6 Meridien Research , Bradenton, Florida.
7
7 Children's Developmental Center , Winter Park, Florida.
8
8 Ironshore Pharmaceuticals & Development, Inc. , Grand Cayman, Cayman Islands .
9
9 Mount Sinai Medical Center , New York, New York.

Abstract

OBJECTIVE:

Evening-dosed HLD200 is a delayed-release and extended-release methylphenidate (DR/ER-MPH) formulation consisting of uniform, dual-layered microbeads with an inner drug-loaded core. DR/ER-MPH is designed to delay the initial release of drug by 8-10 hours, and thereafter, provide a controlled, extended drug release to target onset of effect upon awakening that lasts into the evening. This phase 3 study evaluated the safety and efficacy of DR/ER-MPH on symptoms and temporal at-home functional impairment in children with attention-deficit/hyperactivity disorder (ADHD).

METHODS:

This 3-week, randomized, double-blind, multicenter, placebo-controlled, parallel-group, forced-dose titration trial evaluated DR/ER-MPH (40-80 mg/day) in children aged 6-12 years with ADHD. Primary efficacy endpoint was the ADHD rating scale-IV (ADHD-RS-IV), and the key secondary endpoints were the Before-School Functioning Questionnaire (BSFQ), and Parent Rating of Evening and Morning Behavior-Revised, morning (PREMB-R AM) and evening (PREMB-R PM). Safety measures included spontaneously reported treatment-emergent adverse events (TEAEs) and two TEAEs of special interest, appetite suppression and insomnia (with direct questioning on sleep disturbance).

RESULTS:

One hundred sixty-one participants were included in the intent-to-treat population (DR/ER-MPH, n = 81; placebo, n = 80). After 3 weeks, DR/ER-MPH achieved significant improvements versus placebo in ADHD symptoms (least-squares [LS] mean ADHD-RS-IV: 24.1 vs. 31.2; p = 0.002), and at-home early morning (LS mean BSFQ: 18.7 vs. 28.4; p < 0.001; LS mean PREMB-R AM: 2.1 vs. 3.6; p < 0.001) and late afternoon/evening (LS mean PREMB-R PM: 9.4 vs. 12.2; p = 0.002) functional impairment. Commonly reported TEAEs (≥10%) were insomnia and decreased appetite.

CONCLUSIONS:

DR/ER-MPH was generally well tolerated and demonstrated significant improvements versus placebo in ADHD symptoms and at-home functional impairments in the early morning, late afternoon, and evening in children with ADHD.

KEYWORDS:

attention-deficit/hyperactivity disorder; delayed-release; extended-release; functioning; methylphenidate; symptoms

PMID:
29172680
PMCID:
PMC5567875
DOI:
10.1089/cap.2017.0084
[Indexed for MEDLINE]
Free PMC Article

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