Gao, Le;
Man, Kenneth KC;
Fan, Min;
Ge, Grace MQ;
Lau, Wallis CY;
Cheung, Ching-Lung;
Coghill, David;
... Wong, Ian CK; + view all
(2023)
Treatment with methylphenidate and the risk of fractures among children and young people: A systematic review and self-controlled case series study.
British Journal of Clinical Pharmacology
, 89
(8)
pp. 2519-2528.
10.1111/bcp.15714.
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Abstract
Aims: Animal studies suggest that methylphenidate treatment for around 3 months may lead to less mineralized and weaker appendicular bones. A systematic review was conducted to summarize the evidence from observational studies, and a self-controlled case series study was used to compare the risk before and after treatment initiation. Methods: Literature search was conducted using PubMed, Embase and the Cochrane Library to identify observational studies on methylphenidate and fractures. We also conducted a self-controlled case series study with individuals aged 5–24 years who received methylphenidate treatment and experienced fractures from 2001 to 2020 in Hong Kong. Incidence rate ratios and 95% confidence intervals were calculated by comparing the incidence rate in the methylphenidate-exposed period compared with nonexposed period. Results: Six cohort studies and 2 case–control studies were included in the systematic review. For all-cause fractures, studies found a 39–74% lower risk in treated-attention deficit hyperactivity disorder (ADHD) group compared with untreated ADHD but no difference between stimulants and nonstimulants. Differences between sexes and treatment duration were also found—significant results were shown in males and those with longer treatment duration. Among 43 841 individuals with ADHD medication before the year 2020, 2023 were included in the self-controlled case series analysis. The risks of fractures were lower by 32–41% in different treatment periods when compared with 6 months before treatment initiation. Conclusion: Methylphenidate treatment may lower the risk of all-cause fractures from both study designs; however, further evidence is needed about the treatment duration and sex effect. Conclusions on stress fractures are not yet established, and further research is required.
| Type: | Article |
|---|---|
| Title: | Treatment with methylphenidate and the risk of fractures among children and young people: A systematic review and self-controlled case series study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/bcp.15714 |
| Publisher version: | https://doi.org/10.1111/bcp.15714 |
| Language: | English |
| Additional information: | © 2023 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | clinical pharmacology, drug safety, pharmacoepidemiology, pharmacotherapy,psychopharmacology, psychotropic drugs, systematic review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10166179 |
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