title: Attention-Deficit/Hyperactivity Disorder Medication Treatment Impact on Response to Growth Hormone Therapy: Results from the ANSWER Program, a Non-Interventional Study.
abstract: OBJECTIVE
  To examine whether attention-deficit/hyperactivity disorder (ADHD) stimulant medication modified the linear growth response to growth hormone (GH) treatment in children enrolled in the American Norditropin Studies: Web-Enabled Research Program.
  
  
  METHODS
  Short, GH treatment-naive children with or without GH deficiency (GHD) received GH therapy. A subset also received ADHD stimulant medication (n = 1190), and others did not (n = 7230). Linear mixed models (adjusted means) examined height SDS (HSDS) and body mass index (BMI) SDS from baseline through year 4. Analyses were repeated with ADHD groups matched for baseline age, height, weight, BMI, and sex. Groups with and without GHD were compared between ADHD groups.
  
  
  RESULTS
  Adjusted change in HSDS for the group receiving ADHD stimulant medication was slightly lower than that for patients not receiving stimulant medication at years 1 to 4 (P < .05). However, adjusted change in HSDS was similar between children receiving and not receiving ADHD stimulant medication when matched for baseline measurements. At year 4, 86.7% of patients receiving ADHD stimulant medication, 86.8% of total patients not receiving ADHD stimulant medication, and 84.6% of matched group patients not receiving ADHD stimulant medication achieved HSDS >-2. Year 4 adjusted change in BMI SDS was greater in the patients receiving ADHD stimulant medication compared with both groups not receiving ADHD stimulant medication (P < .05). Patients with GHD showed comparable differences in adjusted change in BMI SDS among the ADHD groups at year 4, whereas patients without GHD showed no significant differences.
  
  
  CONCLUSIONS
  ADHD medication did not affect the linear growth response of children treated with GH when those receiving or not receiving ADHD stimulant medication were matched for baseline measurements. Underlying reasons for the observed greater increase in BMI in patients with GHD concomitantly treated with ADHD medication remain to be elucidated.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01009905.
authors.affiliation: Departments of Pediatric Endocrinology and Metabolism, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Rose
authors.affiliation: Division of Endocrinology, DuPont Hospital for Children, Wilmington, DE.
authors.forename: Grafton
authors.initials: G
authors.lastname: Reeves
authors.affiliation: Novo Nordisk Inc, Plainsboro, NJ.
authors.forename: Robert
authors.initials: R
authors.lastname: Gut
authors.affiliation: Novo Nordisk Inc, Plainsboro, NJ.
authors.forename: John
authors.initials: J
authors.lastname: Germak
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D019382:Human Growth Hormone