Efficacy and Safety of HLD200, Delayed-Release and Extended-Release Methylphenidate, in Children with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

Evening-dosed HLD200 is a delayed-release and extended-release methylphenidate (DR/ER-MPH) formulation consisting of uniform, dual-layered microbeads with an inner drug-loaded core. DR/ER-MPH is designed to delay the initial release of drug by 8-10 hours, and thereafter, provide a controlled, extended drug release to target onset of effect upon awakening that lasts into the evening. This phase 3 study evaluated the safety and efficacy of DR/ER-MPH on symptoms and temporal at-home functional impairment in children with attention-deficit/hyperactivity disorder (ADHD).

METHODS

This 3-week, randomized, double-blind, multicenter, placebo-controlled, parallel-group, forced-dose titration trial evaluated DR/ER-MPH (40-80 mg/day) in children aged 6-12 years with ADHD. Primary efficacy endpoint was the ADHD rating scale-IV (ADHD-RS-IV), and the key secondary endpoints were the Before-School Functioning Questionnaire (BSFQ), and Parent Rating of Evening and Morning Behavior-Revised, morning (PREMB-R AM) and evening (PREMB-R PM). Safety measures included spontaneously reported treatment-emergent adverse events (TEAEs) and two TEAEs of special interest, appetite suppression and insomnia (with direct questioning on sleep disturbance).

RESULTS

One hundred sixty-one participants were included in the intent-to-treat population (DR/ER-MPH, n = 81; placebo, n = 80). After 3 weeks, DR/ER-MPH achieved significant improvements versus placebo in ADHD symptoms (least-squares [LS] mean ADHD-RS-IV: 24.1 vs. 31.2; p = 0.002), and at-home early morning (LS mean BSFQ: 18.7 vs. 28.4; p < 0.001; LS mean PREMB-R AM: 2.1 vs. 3.6; p < 0.001) and late afternoon/evening (LS mean PREMB-R PM: 9.4 vs. 12.2; p = 0.002) functional impairment. Commonly reported TEAEs (≥10%) were insomnia and decreased appetite.

CONCLUSIONS

DR/ER-MPH was generally well tolerated and demonstrated significant improvements versus placebo in ADHD symptoms and at-home functional impairments in the early morning, late afternoon, and evening in children with ADHD.

Effect of Ca2+-independent myosin light chain kinase on different skinned smooth muscle fibers

In various skinned smooth muscle fiber preparations, (porcine carotid artery, rat tail artery, chicken gizzard and Taenia coli from guinea pig) a Ca2+-independent myosin light chain kinase (MLCK) initiated a contraction in absence of Ca2+. While the Ca2+ insensitive MLCK was effective on the vertebrate smooth muscles it did not act on the invertebrate skinned skeletal muscle preparation from Limulus and anterior byssus retractor muscle from Mytilus edulis. The results indicate that in vertebrate smooth muscles phosphorylation is sufficient for activation and that there is no obligatory role for an additional mechanism in initiation of contraction.

The Diffusion of Sulfur 35 in Rubber. Effect of Carbon Black Loading on Sulfur Migration from the Breakers in Large Tires

This work had two principal objectives; in the first place, to make a contribution to clarifying the dependence of the diffusion characteristics of sulfur in rubber upon the carbon black concentration in the compound and secondly, we attempted to study the process of diffusion in vulcanized large pneumatic tires, using two different procedures with special experimental conditions. It may be assumed that the physical processes which lead to the diffusion of one material in another are basically well known. Work by Fick and by Langmuir and Dushman, among others, is especially valuable in explaining the diffusion process. while the first studies of diffusion of sulfur in rubber used optical methods, the application of sulfur 35 has been stressed for this purpose in the last few years. Auerbach and Gehman were first to use such a procedure. They, as well as Bresler, Prjadilowa and Chainman, followed the migration of sulfur into rubber during the diffusion process. The latter authors worked at technically interesting temperatures, from 130° to 150° C. Diffusion coefficients calculated from the experimental data were in the range 1.9×10−7 to 1.6×10−6 cm2/s. Studies by Mozisek and also by Ludwig represent more recent work in the field of sulfur diffusion. Ludwig used a different method than the preceding authors. After the test specimens were vulcanized, they were cut into thin slices with the microtome and the radioactivity which was present in the slices was determined. The excellent and detailed books by Jost, may be consulted by anyone with either a general or special interest in securing information in the field of diffusion.