Evidence map›Paper›PMID 27476490›Full record

Observational studyCNS neuroscience & therapeutics2016

Clinical Impact of Not Achieving Recommended Dose on Duration of Atomoxetine Treatment in Adults with Attention-Deficit/Hyperactivity Disorder.

David B Clemow, Allen W Nyhuis, Rebecca L Robinson

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in CNS neuroscience & therapeutics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 90% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Therapeutic Approaches for ADHD by Developmental Stage and Clinical Presentation.International journal of environmental research and public health · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

David B ClemowLilly USA LLC, Indianapolis, IN, USA.
Allen W NyhuisLilly USA LLC, Indianapolis, IN, USA.
Rebecca L RobinsonLilly USA LLC, Indianapolis, IN, USA.
Eli Lilly (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo 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).

methodsThis 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.

resultsOnly 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.

conclusionEnsuring 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.

Indexed as

AdolescentAdrenergic Uptake InhibitorsAdultAge FactorsAtomoxetine HydrochlorideAttention Deficit Disorder with HyperactivityCohort StudiesDatabases, FactualDose-Response Relationship, DrugDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPredictive Value of TestsTime FactorsAdrenergic Uptake InhibitorsAtomoxetine HydrochlorideAdultAtomoxetineAttention-deficit/hyperactivity disorderDosingLength of therapy

Identifiers

PMID27476490
PMCPMC5129573
OpenAlexW2500671633

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.