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Comparison of the real-world safety of two different long-acting methylphenidate formulations (Medikinet® MR and Concerta®) – a Danish nationwide register-based cohort study

Jakob Ørnberg,Anke Mayer,Oliver Dangel,Richard Ammer

Published 2024 in Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

ABSTRACT

Abstract Background Medikinet® MR and Concerta® are long-acting methylphenidate formulations used for the treatment of pediatric and adult attention-deficit/hyperactivity disorder (ADHD). The two formulations have shown comparable safety profiles in two head-to-head randomized controlled trials. However, real-world studies comparing the safety profiles of these products are not available. Objective This study aimed to compare the real-world safety of Medikinet® MR and Concerta® using register data. Method This population-based cohort study was conducted based on data from Danish registries. The study included patients with continuous long-term (i.e., ≥12 months) exposure to either Medikinet® MR or Concerta® between 1995 and 2018. Outcomes included several selected adverse events of interest. A sensitivity analysis was performed, excluding patients exposed to Concerta® generics. For each outcome, Fisher’s exact test was performed to compare the number of cases between the two groups. Odds ratios (ORs) and 95% confidence intervals were estimated using logistic regression models with patients exposed to Concerta® as the reference group. Results The study population included 1249 patients exposed to Medikinet® MR and 2455 patients exposed to Concerta®. No cases of cerebral arteritis or priapism were identified in either cohort. ORs for sudden death and anorexia could not be calculated due to the absence of cases in the Medikinet® MR cohort. For the remaining outcomes, no statistically significant difference in risk was found between Medikinet® MR-exposed and Concerta®-exposed patients. The sensitivity analysis produced results consistent with those obtained in the main analysis. Conclusions The results of this population-based cohort study indicate that Medikinet® MR and Concerta® have comparable real-world safety profiles.

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