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Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder
AIM: To compare atomoxetine (ATX) length of therapy (LoT) among adults with ADHD who reached the recommended dose of 80 mg/day (ATX ≥ 80) versus those who did not (ATX < 80) analyzed separately in patients prescribed ATX as monotherapy (mono) and in combination with other ADHD medications (combo)...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129573/ https://www.ncbi.nlm.nih.gov/pubmed/27476490 http://dx.doi.org/10.1111/cns.12595 |
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author | Clemow, David B. Nyhuis, Allen W. Robinson, Rebecca L. |
author_facet | Clemow, David B. Nyhuis, Allen W. Robinson, Rebecca L. |
author_sort | Clemow, David B. |
collection | PubMed |
description | AIM: To compare atomoxetine (ATX) length of therapy (LoT) among adults with ADHD who reached the recommended dose of 80 mg/day (ATX ≥ 80) versus those who did not (ATX < 80) analyzed separately in patients prescribed ATX as monotherapy (mono) and in combination with other ADHD medications (combo). METHODS: This was a retrospective observational cohort study of the Truven Health Marketscan Commercial Claims Database from January 1, 2006–September 30, 2013, with a 6‐month preindex period free of ATX (1st ATX claim as index event) and a 1‐year follow‐up. LoT during follow‐up was calculated using prescription claim fill dates and included all days with medication on hand regardless of treatment gaps. RESULTS: Only 45.0% of the 36,076 mono and 77.9% of the 1548 combo patients reached an ATX dose of ≥80 mg/day in 1‐year follow‐up. When patients filled at least one 80 mg prescription, their total days of therapy over the course of a year were significantly greater than if they did not (mono: 159.3 vs. 65.6 days; combo: 237.4 vs. 172.0; P < 0.0001). Across all timepoints examined (Day 14, 30, 60, 90, 210) for mono and combo, ATX ≥ 80 versus ATX < 80 patients had greater mean doses (P < 0.0001). Combo patients had longer ATX LoT than mono patients regardless if they reached 80 mg or not (P < 0.0001), but mono patients LoT was 93.8 days longer for ATX ≥ 80 versus ATX < 80 patients compared to 65.5 days for combo patients. Of patients reaching 80 mg/day, 71.7% of mono and 62.8% of combo patients did so by Day 30. For mono ATX ≥ 80 and ATX < 80 patients, LoT was significantly (P < 0.0001) less in previously treated patients compared to naive patients. CONCLUSION: Ensuring adult ADHD patients are treated with ATX at a target dose of 80 mg/day is an important clinical consideration for maximizing patient days on therapy, which can be important for treatment optimization. |
format | Online Article Text |
id | pubmed-5129573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-51295732016-11-30 Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder Clemow, David B. Nyhuis, Allen W. Robinson, Rebecca L. CNS Neurosci Ther Original Articles AIM: To compare atomoxetine (ATX) length of therapy (LoT) among adults with ADHD who reached the recommended dose of 80 mg/day (ATX ≥ 80) versus those who did not (ATX < 80) analyzed separately in patients prescribed ATX as monotherapy (mono) and in combination with other ADHD medications (combo). METHODS: This was a retrospective observational cohort study of the Truven Health Marketscan Commercial Claims Database from January 1, 2006–September 30, 2013, with a 6‐month preindex period free of ATX (1st ATX claim as index event) and a 1‐year follow‐up. LoT during follow‐up was calculated using prescription claim fill dates and included all days with medication on hand regardless of treatment gaps. RESULTS: Only 45.0% of the 36,076 mono and 77.9% of the 1548 combo patients reached an ATX dose of ≥80 mg/day in 1‐year follow‐up. When patients filled at least one 80 mg prescription, their total days of therapy over the course of a year were significantly greater than if they did not (mono: 159.3 vs. 65.6 days; combo: 237.4 vs. 172.0; P < 0.0001). Across all timepoints examined (Day 14, 30, 60, 90, 210) for mono and combo, ATX ≥ 80 versus ATX < 80 patients had greater mean doses (P < 0.0001). Combo patients had longer ATX LoT than mono patients regardless if they reached 80 mg or not (P < 0.0001), but mono patients LoT was 93.8 days longer for ATX ≥ 80 versus ATX < 80 patients compared to 65.5 days for combo patients. Of patients reaching 80 mg/day, 71.7% of mono and 62.8% of combo patients did so by Day 30. For mono ATX ≥ 80 and ATX < 80 patients, LoT was significantly (P < 0.0001) less in previously treated patients compared to naive patients. CONCLUSION: Ensuring adult ADHD patients are treated with ATX at a target dose of 80 mg/day is an important clinical consideration for maximizing patient days on therapy, which can be important for treatment optimization. John Wiley and Sons Inc. 2016-07-31 /pmc/articles/PMC5129573/ /pubmed/27476490 http://dx.doi.org/10.1111/cns.12595 Text en © 2016 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Clemow, David B. Nyhuis, Allen W. Robinson, Rebecca L. Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder |
title | Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder |
title_full | Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder |
title_fullStr | Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder |
title_full_unstemmed | Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder |
title_short | Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention‐Deficit/Hyperactivity Disorder |
title_sort | clinical impact of not achieving recommended dose on duration of atomoxetine treatment in adults with attention‐deficit/hyperactivity disorder |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129573/ https://www.ncbi.nlm.nih.gov/pubmed/27476490 http://dx.doi.org/10.1111/cns.12595 |
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