PDF(Pubmed)
Abstract：
OBJECTIVE: To systematically evaluate the safety and efficacy of antioxidant therapy in children and adolescents with attention deficit hyperactivity disorder (ADHD).
METHODS: Randomized controlled trials and prospective studies on antioxidant therapy in children and adolescents with ADHD were searched in PubMed, Embase, and Cochrane Library from the inception of databases to November 12, 2022. Two investigators independently screened the literature, extracted data, and evaluated the quality of the included studies. Network meta-analysis (PROSPERO registration number CRD 42023382824) was carried out by using R Studio 4.2.1.
RESULTS: 48 studies involving 12 antioxidant drugs (resveratrol, pycnogenol, omega-3, omega-6, quercetin, phosphatidylserine, almond, vitamin D, zinc, folic acid, ginkgo biloba, Acetyl-L-carnitine) were finally included, with 3,650 patients. Network meta-analysis showed that omega-6 (0.18), vitamin D (0.19), and quercetin (0.24) were the top three safest drugs according to SUCRA. The omega-3 (SUCRA 0.35), pycnogenol (SUCRA 0.36), and vitamin D (SUCRA 0.27) were the most effective in improving attention, hyperactivity, and total score of Conners\' parent rating scale (CPRS), respectively. In terms of improving attention, hyperactivity, and total score of Conners\' teacher rating scale (CTRS), pycnogenol (SUCRA 0.32), phosphatidylserine+omega-3 (SUCRA 0.26), and zinc (SUCRA 0.34) were the most effective, respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Parent, the optimal agents were phosphatidylserine (SUCRA 0.39), resveratrol+MPH (SUCRA 0.24), and phosphatidylserine (SUCRA 0.34), respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Teacher, pycnogenol (SUCRA 0.32), vitamin D (SUCRA 0.31) and vitamin D (SUCRA 0.18) were the optimal agents, respectively. The response rate of omega-3+6 was the highest in CGI (SUCRA 0.95) and CPT (SUCRA 0.42).
CONCLUSIONS: The rankings of safety and efficacy of the 12 antioxidants vary. Due to the low methodological quality of the included studies, the probability ranking cannot fully explain the clinical efficacy, and the results need to be interpreted with caution. More high-quality studies are still needed to verify our findings.
METHODS: Randomized controlled trials and prospective studies on antioxidant therapy in children and adolescents with ADHD were searched in PubMed, Embase, and Cochrane Library from the inception of databases to November 12, 2022. Two investigators independently screened the literature, extracted data, and evaluated the quality of the included studies. Network meta-analysis (PROSPERO registration number CRD 42023382824) was carried out by using R Studio 4.2.1.
RESULTS: 48 studies involving 12 antioxidant drugs (resveratrol, pycnogenol, omega-3, omega-6, quercetin, phosphatidylserine, almond, vitamin D, zinc, folic acid, ginkgo biloba, Acetyl-L-carnitine) were finally included, with 3,650 patients. Network meta-analysis showed that omega-6 (0.18), vitamin D (0.19), and quercetin (0.24) were the top three safest drugs according to SUCRA. The omega-3 (SUCRA 0.35), pycnogenol (SUCRA 0.36), and vitamin D (SUCRA 0.27) were the most effective in improving attention, hyperactivity, and total score of Conners\' parent rating scale (CPRS), respectively. In terms of improving attention, hyperactivity, and total score of Conners\' teacher rating scale (CTRS), pycnogenol (SUCRA 0.32), phosphatidylserine+omega-3 (SUCRA 0.26), and zinc (SUCRA 0.34) were the most effective, respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Parent, the optimal agents were phosphatidylserine (SUCRA 0.39), resveratrol+MPH (SUCRA 0.24), and phosphatidylserine (SUCRA 0.34), respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Teacher, pycnogenol (SUCRA 0.32), vitamin D (SUCRA 0.31) and vitamin D (SUCRA 0.18) were the optimal agents, respectively. The response rate of omega-3+6 was the highest in CGI (SUCRA 0.95) and CPT (SUCRA 0.42).
CONCLUSIONS: The rankings of safety and efficacy of the 12 antioxidants vary. Due to the low methodological quality of the included studies, the probability ranking cannot fully explain the clinical efficacy, and the results need to be interpreted with caution. More high-quality studies are still needed to verify our findings.
摘要：
目的：系统评价抗氧化治疗儿童和青少年注意缺陷多动障碍（ADHD）的安全性和有效性。
方法：在PubMed,Embase,和Cochrane图书馆从数据库开始到2022年11月12日。两名研究者独立筛选了文献，提取的数据，并对纳入研究的质量进行评价。使用RStudio4.2.1进行网络荟萃分析（PROSPERO注册号CRD42023382824）。
结果：48项研究涉及12种抗氧化药物（白藜芦醇，碧萝醇,omega-3,omega-6,槲皮素,磷脂酰丝氨酸,杏仁,维生素D,锌，叶酸,银杏叶,乙酰-L-肉碱）最终包括在内，3,650名患者。网络荟萃分析显示，ω-6(0.18)，维生素D（0.19），根据SUCRA，槲皮素（0.24）是前三名最安全的药物。omega-3（SUCRA0.35），碧萝诺（SUCRA0.36），维生素D（SUCRA0.27）在改善注意力方面最有效，多动症,和康纳斯家长评定量表(CPRS)的总分，分别。在提高注意力方面,多动症,和康纳斯教师评定量表(CTRS)总分，碧萝醇（SUCRA0.32），磷脂酰丝氨酸+omega-3（SUCRA0.26），锌(SUCRA0.34)是最有效的，分别。在提高注意力方面,多动症评分量表-家长，最佳药物是磷脂酰丝氨酸(SUCRA0.39)，白藜芦醇+MPH（SUCRA0.24），和磷脂酰丝氨酸（SUCRA0.34），分别。在提高注意力方面,多动症评分量表的多动症和总分-教师，碧萝醇（SUCRA0.32），维生素D(SUCRA0.31)和维生素D(SUCRA0.18)是最佳药物，分别。在CGI（SUCRA0.95）和CPT（SUCRA0.42）中，omega-36的响应率最高。
结论：12种抗氧化剂的安全性和有效性排名各不相同。由于纳入研究的方法学质量较低，概率排序不能完全解释临床疗效，结果需要谨慎解释。仍需要更多高质量的研究来验证我们的发现。
方法：在PubMed,Embase,和Cochrane图书馆从数据库开始到2022年11月12日。两名研究者独立筛选了文献，提取的数据，并对纳入研究的质量进行评价。使用RStudio4.2.1进行网络荟萃分析（PROSPERO注册号CRD42023382824）。
结果：48项研究涉及12种抗氧化药物（白藜芦醇，碧萝醇,omega-3,omega-6,槲皮素,磷脂酰丝氨酸,杏仁,维生素D,锌，叶酸,银杏叶,乙酰-L-肉碱）最终包括在内，3,650名患者。网络荟萃分析显示，ω-6(0.18)，维生素D（0.19），根据SUCRA，槲皮素（0.24）是前三名最安全的药物。omega-3（SUCRA0.35），碧萝诺（SUCRA0.36），维生素D（SUCRA0.27）在改善注意力方面最有效，多动症,和康纳斯家长评定量表(CPRS)的总分，分别。在提高注意力方面,多动症,和康纳斯教师评定量表(CTRS)总分，碧萝醇（SUCRA0.32），磷脂酰丝氨酸+omega-3（SUCRA0.26），锌(SUCRA0.34)是最有效的，分别。在提高注意力方面,多动症评分量表-家长，最佳药物是磷脂酰丝氨酸(SUCRA0.39)，白藜芦醇+MPH（SUCRA0.24），和磷脂酰丝氨酸（SUCRA0.34），分别。在提高注意力方面,多动症评分量表的多动症和总分-教师，碧萝醇（SUCRA0.32），维生素D(SUCRA0.31)和维生素D(SUCRA0.18)是最佳药物，分别。在CGI（SUCRA0.95）和CPT（SUCRA0.42）中，omega-36的响应率最高。
结论：12种抗氧化剂的安全性和有效性排名各不相同。由于纳入研究的方法学质量较低，概率排序不能完全解释临床疗效，结果需要谨慎解释。仍需要更多高质量的研究来验证我们的发现。
