No Evidence for Predictors of Response to Atomoxetine Treatment of Attention-Deficit/Hyperactivity Disorder Symptoms in Children and Adolescents with Autism Spectrum Disorder

摘要: [Author Affiliation]Myriam Harfterkamp. 1 Department of Psychiatry, University Groningen, Medical Center The Netherlands.Dennis van der Meer. Netherlands.Gigi Loo-Neus. 2 Karakter Child and Adolescent Psychiatry Center, Nijmegen, Netherlands.Jan K. Buitelaar. Netherlands. 3 Cognitive Neuroscience, Radboud Nijmegen Netherlands.Ruud B. Minderaa. Netherlands.Pieter J. Hoekstra. Netherlands.Funding: This study was funded by Eli Lilly company.Address correspondence to: Myriam Harfterkamp, MD, Hanzeplein 1, Groningen 9717 ER, Netherlands, E-mail: m.a.harfterkamp@umcg.nlTo Editor:Attention-deficit/hyperactivity disorder (ADHD) symptoms are frequently observed in children adolescents with an autism spectrum (ASD); ∼30-80% patients ASD meet criteria for ADHD (Rommelse et al. 2010). presence is a serious clinical problem; such dual diagnosis have more severe overall impairment, which complicates these patients' therapeutic management (Gadow 2006; Holtmann 2007). Although combination diagnoses precluded the text revision fourth edition Diagnostic Statistical Manual Mental Disorders (DSM-IV-TR), fifth (DSM-V) has now made it possible to classify both disorders at same time (American Psychiatric Association 2000, 2013).Several small-scale, mostly open-label studies (Jou 2005; Arnold Posey Troost all. Charnsil 2011; Zeiner Fernandez-Jaen 2013) suggested that atomoxetine, noradrenergic reuptake inhibitor, might be promising treatment ASD. We confirmed preliminary findings double-blind placebo-controlled trial followed extension period concomitant symptoms, demonstrated superior efficacy atomoxetine compared placebo, as rated investigator-administered ADHD-Rating Scale (ADHD-RS), good tolerability (Harfterkamp 2012). also showed continued up total length 28 weeks led further improvement ASD, decrease adverse events 2013).However, group do not necessarily predict response individual patient. From perspective worthwhile know most likely atomoxetine. A meta-analysis meta-regression analysis evaluated safety (without ASD) across nine randomized trials (in 1150 on atomoxetine) (Cheng These analyses effective higher baseline symptom count, whereas male gender, comorbid oppositional defiant (ODD), hyperactive/impulsive type were associated somewhat smaller reductions.However, another large-scale 618 treated pooled six industry-sponsored United States randomized, double-blind, ruled out sex, type, race, previous stimulant use, ODD, age, CYP2D6 genotype status predictors achieving much improved (Newcorn …