Growth Trajectories of Youth with Attention-Deficit/Hyperactivity Disorder Treated with Delayed-Release/Extended-Release Methylphenidate: A Pilot Database Analysis of Real-World Data

This work was sponsored by Ironshore, manufacturer of DR/ER-MPH (formerly HLD200) Purpose: Stimulants are associated with a slowed growth rate in youth with attention-deficit/hyperactivity disorder (ADHD). DR/ER-MPH (JORNAY PM®) is an evening-dosed, delayed-release and extended-release methylphenidate released in the colon; it has no immediate-release component and provides a dose-dependent duration of effect. We report real-world weight and height changes in patients newly prescribed DR/ER-MPH versus two branded stimulants, osmotic release oral system (OROS) MPH (Concerta®) and lisdexamfetamine dimesylate (LDX; Vyvanse®). Methods: Patients (aged 6–17y) newly prescribed DR/ER-MPH, OROS MPH, or LDX between July 2019 and June 2020 were retrospectively identified from professional fee (Dx) and prescription claim (Rx) databases (New Data Warehouse, IQVIA). Differences in weight and height trajectories based on data from a linked electronic medical records database (Ambulatory EMR, IQVIA) were modeled with repeated measures mixed effects models (DR/ER-MPH vs OROS MPH or LDX). Results: Analyses included 83, 240, and 403 patients prescribed DR/ER-MPH, OROS MPH, and LDX, respectively. There were no significant differences in growth measures at baseline. After 1 year of treatment, model-adjusted weight (+6.1kg vs +5.3kg, P=0.50) and height (+5.7cm vs +5.1cm; P=0.57) trajectories increased numerically for DR/ER-MPH versus OROS MPH. Versus LDX, height trajectory (+5.7cm vs +4.9cm; P=0.23) of DR/ER-MPH increased numerically and weight trajectory (+7.2kg vs +2.7kg; P