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AISRS useful in measuring methylphenidate therapy for adults with ADHD

Wednesday, December 12 2007 | Comments
Evidence Grade 0 What's This?
The Adult Attention-Deficit/Hyperactivity Disorder Investigator Symptom Rating Scale (AISRS) is a sensitive instrument that measures the effect of methylphenidate treatment on the signs and symptoms of ADHD among adults, new data reveal.

The AISRS is a modified version of the ADHD Rating Scale that more accurately reflects the impact and severity of ADHD among adults, the authors noted. It is a clinician-administered scale that measures all 18 symptoms of adult ADHD using a Likert scale (from 0 [not present] to 3 [severe]).

The researchers examined data from 2 randomized trials that used AISRS to evaluate ADHD symptom improvement with methylphenidate. Both similarly designed six-week trials included patients aged 19 to 60 years with diagnosed ADHD. The data were pooled to create 3 study groups: placebo (n=116), immediate-release methylphenidate 3 times daily (n=102), and OROS methylphenidate once daily (n=67).

Results showed that the AISRS was a sensitive measure for the drugs' effects in adults with ADHD, as the active treatment cohorts had significantly better improvement in symptoms than did the placebo cohort. Specifically, 80% (n=80) of patients who received IR methylphenidate and 69% (n=46) of patients who received OROS methylphenidate experienced a 30% reduction in AISRS scores from baseline compared with 40% (n=46) of placebo-treated patients who did so.

Furthermore, both the IR methylphenidate and OROS methylphenidate groups were significantly more likely to have a 30% reduction in symptoms relative to placebo (P<.001). There was no difference between the active treatment groups.

Because of the demonstrated sensitivity of the AISRS, it was selected as the primary rating scale for a 7-week, randomized, double-blind, dose-titration trial of OROS methylphenidate in doses of 36 mg/day, 54 mg/d, 72 mg/d, 90 mg/d, or 108 mg/d versus placebo in 229 adults with ADHD. The patients had an AISRS score of >=24 at baseline. The primary endpoint of the study was the change from baseline in the AISRS total score at the final visit.

In this study, the AISRS was shown to be sensitive to medication treatment effects in adults with ADHD.

Further results of this study are expected to be presented at a future meeting.

"The AISRS is an instrument that adequately and sensitively measures the impact of methylphenidate treatment on adult signs and symptoms of ADHD," the authors concluded. (Spencer T, et al. Poster 209.)

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