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首页> 外文期刊>Journal of child and adolescent psychopharmacology >Weight and Height in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Longitudinal Database Study Assessing the Impact of Guanfacine, Stimulants, and No Pharmacotherapy
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Weight and Height in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Longitudinal Database Study Assessing the Impact of Guanfacine, Stimulants, and No Pharmacotherapy

机译：儿童和青少年的体重和高度具有关注缺陷/多动障碍：纵向数据库研究评估舌芬，兴奋剂和药物治疗的影响

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Objectives: To assess the impact of long-term pharmacotherapy with guanfacine immediate- or extended-release (GXR), administered alone or as an adjunctive to a stimulant, on weight and height in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Data were extracted from U.S. Department of Defense medical records for patients 4-17 years of age at index date (initiation of any study medication following a year without ADHD medications, or diagnosis if unmedicated) with weight/height measurements for the analysis period (January 2009-June 2013) and the previous year (baseline). Longitudinal weight and height z-scores were analyzed using multivariable regression in three cohorts: guanfacine (initial period of guanfacine exposure), first-line stimulant monotherapy (initial period of exposure), and unmedicated. Guanfacine cohort subgroups were based on previous/concurrent stimulant exposure. Results: The weight analyses included 47,910 patients (66.8% male) and the height analyses 41,248 (67.2% male). Mean initial exposure in the weight analyses was 237 days (standard deviation [SD] = 258, median = 142) for guanfacine and 257 days (SD = 284, median = 151) for first-line stimulant monotherapy, and was similar in the height analyses. Modeling indicated that guanfacine monotherapy was not associated with clinically meaningful deviations from normal z-score trajectories for weight (first-line, n = 943; nonfirst-line, n = 796) or height (first-line, n = 741; nonfirst-line, n = 644). In patients receiving guanfacine adjunctive to a stimulant, modeled weight (n = 1657) and height (n = 1343) z-scores followed declining trajectories. In this subgroup, mean standardized weight/height had decreased during previous stimulant monotherapy. For first-line stimulant monotherapy, modeled weight (n = 32,999) and height (n = 28,470) z-scores followed declining trajectories during year 1. In the unmedicated cohort, modeled weight (n = 11,515) and height (n = 10,050) z-scores were stable. Conclusions: Guanfacine monotherapy (first-line or nonfirst-line) was not associated with marked deviations from normal growth in this modeling study of children and adolescents with ADHD. In contrast, growth trajectories followed an initially declining course with stimulants, whether given alone or with adjunctive guanfacine.
机译：目的：评估长期药物治疗与关菲素立即或延长释放（GXR）的影响，单独给药或作为兴奋剂的辅助，对儿童和青少年疾病的重量和青少年（ADHD） ）。方法：在指数日期为4-17岁的患者的美国国防部医疗记录中提取数据（在没有ADHD药物的情况下启动任何研究药物，或者如果未确诊）分析期的重量/高度测量（2009年1月至2013年6月）和去年（基线）。在三个队列中使用多变量回归分析纵向重量和高度Z分析：冠翅尼（冠霉素曝光的初始时期），一线兴奋剂单疗法（暴露初期），并不医学。 Guanfacine Cohort亚组基于先前/并发兴奋剂暴露。结果：重量分析包括47,910名患者（男性66.8％）和高度分析41,248（男性67.2％）。平均初始暴露在重量分析中为237天（标准偏差[SD] = 258，中位数= 142），用于一线兴奋单疗法的257天（SD = 284，中位数= 151），在高度中相似分析。建模表明，胍芬啡因单药治疗与重量正常Z分数轨迹的临床有意义的偏差无关（一线，n = 943;非漏洞线，n = 796）或高度（第一线，n = 741;无限制 - 线，n = 644）。在接受舌芬的患者中促进兴奋剂，建模重量（n = 1657）和高度（n = 1343）z分数，然后下降轨迹。在该亚组中，在先前的兴奋剂单疗法中，平均标准化重量/高度减少。对于一线兴奋剂单疗法，建模重量（n = 32,999）和高度（n = 28,470）z分数在1年期间倾斜的轨迹。在未确诊的群组中，建模的重量（n = 11,515）和高度（n = 10,050） Z分数稳定。结论：瓜菲岛单药治疗（一线或非漏洞线）与具有ADHD的儿童和青少年建模研究的正常生长明显偏差无关。相比之下，生长轨迹随后是初始下降的疗程，无论单独给药还是用辅助冠状物。

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