TY - JOUR
T1 - Trajectories of Growth Associated With Long-Term Stimulant Medication in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder
AU - MTA Cooperative Group
AU - Greenhill, Laurence L.
AU - Swanson, James M.
AU - Hechtman, Lily
AU - Waxmonsky, James
AU - Arnold, L. Eugene
AU - Molina, Brooke S.G.
AU - Hinshaw, Stephen P.
AU - Jensen, Peter S.
AU - Abikoff, Howard B.
AU - Wigal, Timothy
AU - Stehli, Annamarie
AU - Howard, Andrea
AU - Hermanussen, Michael
AU - Hanć, Tomasz
N1 - Funding Information:
This work was supported by cooperative grants and contracts from National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) to the following: University of California-Berkeley: U01 MH50461, N01MH12009, and HHSN271200800005-C; DA-8-5550; Duke University: U01 MH50477, N01MH12012, and HHSN271200800009-C; DA-8-5554; University of California-Irvine: U01 MH50440, N01MH 12011, and HHSN271200800006-C; DA-8-5551; Research Foundation for Mental Hygiene (New York State Psychiatric Institute/Columbia University): U01 MH50467, N01 MH12007, and HHSN271200800007-C; DA-8-5552; Long Island Jewish Medical Center: U01-MH50453; New York University: N01MH 12004 and HHSN271200800004-C; DA-8-5549; University of Pittsburgh: U01 MH50467, N01 MH 12010, and HHSN 271200800008C; DA-8-5553; and McGill University: N01MH12008 and HHSN271200800003-C); DA-8-5548. Continuation support was provided by NIDA. Funding support for J.T.M. was provided by NIDA, US, K23 DA032577.Disclosure: Dr. Greenhill has received support from the Klingenstein Third Generation Foundation and the REACH Foundation. Dr. Hechtman has received research support, served on advisory boards, and has been a speaker for Ortho Janssen, Purdue Pharma, Iron Shore, and Shire and has received book royalties from Guilford, APA, John Hopkins University Press, and Oxford University Press. Dr. Waxmonsky has received research funding from the National Institutes of Health (NIH), Supernus, and Pfizer and has served on the advisory board for Noven, Iron Shore, NLS Pharma, and Purdue Pharma. During this writing of this paper, his time was in part supported by grant MH083692. Dr. Arnold has received research funding from Curemark, Forest, Eli Lilly and Co., Neuropharm, Novartis, Noven, Shire, Young-Living, NIH, Autism Speaks, Supernus, and Roche/Genentech; has consulted with or been on advisory boards for Arbor, Gowlings, Neuropharm, Novartis, Noven, Organon, Otsuka, Pfizer, Roche, Seaside Therapeutics, Sigma Tau, Shire, Tris Pharma, and Waypoint; and has received travel support from Noven. Dr. Jensen has received unrestricted educational grants from Shire, Inc., has served as a consultant to Shire, Inc., and is a shareholder of an evidence-based practices consulting company (CATCH Services, LLC). Dr. Wigal has received research funding from Akili, Ironshore Pharmaceuticals, Neurolife Sciences, Neurovance, NuTec, Pfizer, Purdue, Rho, Rhodes, Shire, Sunovion, and Tris Pharma; has consulted with or been on advisory boards for Cingulate, Ironshore Pharmaceuticals, NeuroLife Sciences, NuTec, Otsuka, Pfizer, Purdue, Rho, Rhodes, Shire, Sunovion, Touchpoint, and Tris Pharma. Dr. Hanć has received travel support from MEDICE Arzneimittel Putter GmbH and Co. KG. Drs. Swanson, Molina, Hinshaw, Abikoff, Howard, and Hermussen and Ms. Stehli have reported no biomedical financial interests or potential conflicts of interest.
Publisher Copyright:
© 2019 American Academy of Child and Adolescent Psychiatry
PY - 2020/8
Y1 - 2020/8
N2 - Objective: To estimate long-term stimulant treatment associations on standardized height, weight, and body mass index trajectories from childhood to adulthood in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA). Method: Of 579 children with DSM-IV ADHD−combined type at baseline (aged 7.0–9.9 years) and 289 classmates (local normative comparison group [LNCG]), 568 and 258 respectively, were assessed 8 times over 16 years (final mean age = 24.7). Parent interview data established subgroups with self-selected Consistent (n = 53, 9%), Inconsistent (n = 374, 66%), and Negligible (n = 141, 25%) stimulant medication use, as well as patients starting stimulants prior to MTA entry (n = 211, 39%). Height and weight growth trajectories were calculated for each subgroup. Results: Height z scores trajectories differed among subgroups (F = 2.22, p < .0001) and by stimulant use prior to study entry (F = 2.22, p < .001). The subgroup-by-assessment interaction was significant (F = 2.81, p < .0001). Paired comparisons revealed significant subgroup differences at endpoint: Consistent was shorter than Negligible (−0.66 z units /−4.06 cm /1.6 inches, t = −3.17, p < 0.0016), Consistent shorter than Inconsistent (−0.45 z units /−2.74 cm /−1.08 inches, t = −2.39, p < .0172), and the Consistent shorter than LNCG (−0.54 z units/+3.34 cm/ 1.31 inches, t = −3.30, p < 0.001). Weight z scores initially diverged among subgroups, converged in adolescence, and then diverged again in adulthood when the Consistent outweighed the LNCG (+ 3.561 z units /+7.47 kg /+16.46 lb, p < .0001). Conclusion: Compared with those negligibly medicated and the LNCG, 16 years of consistent stimulant treatment of children with ADHD in the MTA was associated with changes in height trajectory, a reduction in adult height, and an increase in weight and body mass index. Clinical trial registration information: Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); https://clinicaltrials.gov/; NCT00000388.
AB - Objective: To estimate long-term stimulant treatment associations on standardized height, weight, and body mass index trajectories from childhood to adulthood in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA). Method: Of 579 children with DSM-IV ADHD−combined type at baseline (aged 7.0–9.9 years) and 289 classmates (local normative comparison group [LNCG]), 568 and 258 respectively, were assessed 8 times over 16 years (final mean age = 24.7). Parent interview data established subgroups with self-selected Consistent (n = 53, 9%), Inconsistent (n = 374, 66%), and Negligible (n = 141, 25%) stimulant medication use, as well as patients starting stimulants prior to MTA entry (n = 211, 39%). Height and weight growth trajectories were calculated for each subgroup. Results: Height z scores trajectories differed among subgroups (F = 2.22, p < .0001) and by stimulant use prior to study entry (F = 2.22, p < .001). The subgroup-by-assessment interaction was significant (F = 2.81, p < .0001). Paired comparisons revealed significant subgroup differences at endpoint: Consistent was shorter than Negligible (−0.66 z units /−4.06 cm /1.6 inches, t = −3.17, p < 0.0016), Consistent shorter than Inconsistent (−0.45 z units /−2.74 cm /−1.08 inches, t = −2.39, p < .0172), and the Consistent shorter than LNCG (−0.54 z units/+3.34 cm/ 1.31 inches, t = −3.30, p < 0.001). Weight z scores initially diverged among subgroups, converged in adolescence, and then diverged again in adulthood when the Consistent outweighed the LNCG (+ 3.561 z units /+7.47 kg /+16.46 lb, p < .0001). Conclusion: Compared with those negligibly medicated and the LNCG, 16 years of consistent stimulant treatment of children with ADHD in the MTA was associated with changes in height trajectory, a reduction in adult height, and an increase in weight and body mass index. Clinical trial registration information: Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); https://clinicaltrials.gov/; NCT00000388.
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U2 - 10.1016/j.jaac.2019.06.019
DO - 10.1016/j.jaac.2019.06.019
M3 - Article
C2 - 31421233
AN - SCOPUS:85075522990
SN - 0890-8567
VL - 59
SP - 978
EP - 989
JO - Journal of the American Academy of Child Psychiatry
JF - Journal of the American Academy of Child Psychiatry
IS - 8
ER -
