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Initiated and funded by Takeda Pharmaceuticals Limited.

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The Impact of ADHD

Adults with ADHD have worse outcomes in life compared with healthy controls.1-4

* Data from a study analysing accident rates in treated ADHD patients vs. untreated ADHD patients.

Difference taken from community control data.

NICE recommends lisdexamfetamine (Elvanse Adult) as a first-line medication choice for adults with ADHD5

Offer lisdexamfetamine or methylphenidate as first-line pharmacological treatment for adults with ADHD.5

NICE guidelines NG87

When prescribing stimulants for ADHD, think about modified-release once-daily preparations for the following reasons:5

  • Convenience
  • Improving adherence
  • Reducing stigma (because there is no need to take medication in the workplace)
  • The risk of stimulant misuse and diversion with immediate-release preparations
  • Their pharmacokinetic profiles

Prodrug technology helps deliver consistent symptom control6-8

Elvanse Adult is a modified release once-daily stimulant for consistent symptom control.6-8

Watch the pro-drug technology video here

Elvanse Adult provides improvements in core ADHD symptoms in adults with ADHD for up to 14 hours.17 (PERMP total score, primary endpoint).

Adapted from Wigal T et al. Behav Brain Func 2010. *p<0.001 vs. placebo. Dose taken at 7am.

LS, least squares; PERMP, Permanent Product Measure of Performance; SE, standard error.

Wigal T, et al. 2010. A 4 phase study evaluating the efficacy and safety of Elvanse Adult in 127 adults aged 18-55 years. Patients underwent a 4-week open-label dose-optimisation phase, followed by a 2-week randomised, double-blind, placebo-controlled, 2-way crossover phase. Patients received Elvanse Adult 30 mg, 50 mg or 70 mg, or placebo. All subjects were required to have a diagnosis of ADHD that met the DSM-IV-TR criteria. Primary endpoint: Total PERMP scale scores averaged over all post-dose time points assessed during visits 5 and 6.

Dose titration of Elvanse Adult

Increase dose by 20mg increments, at weekly intervals, if necessary.6

When initiating Elvanse Adult in your patients, please write prescriptions like this:

Elvanse Adult 30 mg capsules.

Take one orally each morning for 28 (twenty-eight) days.

Please supply patient with 28 (twenty-eight) capsules.

Elvanse Adult can improve patients’ symptoms, executive functioning and quality of life18,19

Significantly improves ADHD symptoms vs placebo at 4 weeks, with results seen as early as week 1
(ADHD-RS-IV scores, p<0.0001 for all 3 doses, n=420).20
Adults self-report significant improvements in executive functioning vs placebo at 10 weeks
(p<0.0001, BRIEF-A GEC T-score, primary endpoint, n=161).18
Patients reported greater improvements in QoL vs placebo patients on all AIM-A domains at 10 weeks
(secondary endpoint, p<0.0302 for all, n=161).19
What could this mean for your patients?6,18-22
  • Able to make plans and organise
  • Attentive at work
  • Managing household finances
  • Maintaining good relationships
  • Meeting deadlines

ADHD-RS-IV = ADHD Rating Scale IV; BRIEF-A = Behaviour Rating Inventory of Executive Function – Adult Version;

GEC = Global Executive Composite AIM-A = Adult ADHD Impact Module.

Adler LA et al. J Clin Psychiatry 2008: A double-blind, placebo-controlled study to assess the efficacy and safety of 30, 50 and 70 mg/day lisdexamfetamine vs placebo in 420 adults with ADHD.

Adler LA et al. J Clin Psychiatry 2013: A randomised, double-blind study to evaluate the efficacy of 30, 50 and 70 mg/day lisdexamfetamine vs placebo for executive function deficits in 161 adults with ADHD and clinically significant executive function impairment.

Adler LA et al. BMJ Psychiatry 2013. A randomised, double-blind, multicentre, placebo-controlled, parallel-group study to assess the quality of life in 161 adults with ADHD and executive function impairment treated with 30, 50 and 70 mg/day lisdexamfetamine vs placebo.

Indication, Safety and Tolerability

  • Elvanse Adult is indicated as part of a comprehensive treatment programme for attention deficit/hyperactivity disorder in adults. Elvanse Adult is not indicated in all adult patients and the decision to use the medicinal product must take into consideration the profile of the patient, including a thorough assessment of the severity and chronicity of the patient’s symptoms, the potential for abuse, misuse or diversion, and clinical response to any previous pharmacotherapies for the treatment of ADHD. Treatment must be under the supervision of a specialist in behavioural disorders.6
  • The most frequently reported adverse reactions (>1/10) with Elvanse Adult are decreased appetite, dry mouth, headache and insomnia.6
  • Patients should be monitored for the risk of diversion, misuse, and abuse of Elvanse Adult. Please see the Summary of Product Characteristics6 for a full list of adverse events and guidance on patient monitoring.

Summary

Elvanse Adult:

  • Recommended by NICE as a first-line medication choice for adults with ADHD.5
  • Prodrug technology for consistent symptom control.8,16
  • Take once-daily for 14-hour core symptom control.6,17
  • Helps improve executive function and quality of life vs. placebo at 10 weeks.18,19
  • The most frequently reported adverse reactions (≥1/10) with Elvanse Adult are decreased appetite, dry mouth, headache and insomnia.17

Useful Resources

Watch the Elvanse Adult mode of action video here

Understanding ADHD in Adults

Information for adults who have been diagnosed with ADHD

  • Causes and symptoms of ADHD
  • How ADHD is diagnosed, treated and managed
  • How it may affect your life
  • Tips for self-care and where to look for more help

Elvanse Adult and you

Information for adults with ADHD who have been prescribed this treatment

  • What Elvanse Adult is
  • How to take it
  • What to expect when taking it
  • How it could help control the symptoms of ADHD

The ADHD eForum

Provides access to educational meetings and webinars, including a library to download support materials for you and your patients

Visit request

Request a visit from a Takeda representative to discuss Elvanse Adult

References

  1. Chang Z, et al. JAMA Psychiatry 2017;74(6):597-603
  2. Barkley RA, et al. ADHD in Adults. New York: Guilford Press, 2008
  3. Biederman J, et al. J Clin Psychiatry 2006;67(4):524-40
  4. Dalsgaard S, et al. Lancet 2015;385:2190-6
  5. NICE NG87 (2018). Attention deficit hyperactivity disorder: diagnosis and management. Available at: www.nice.org.uk/guidance/ng87 (accessed May 2019)
  6. Elvanse Adult. Summary of Product Characteristics, Shire Pharmaceuticals Ltd, 2017. Available at: www.medicines.org.uk/emc/product/6828/smpc (accessed May 2019)
  7. Sharman J, Pennick M, Neuropsychiatr Dis Treat 2014;10:2275-80
  8. Ermer C, et al. Clin Drug Investig 2016;36:341-56
  9. Goodman DW. P T 2010; 35(5): 273–87
  10. Lopez FA & Leroux JR. ADHD Atten Def Hyp Disord 2013; 5: 249–65
  11. Pennick M. Neuropsychiatr Dis Treat 2010; 6: 317–27
  12. Shojaei A et al. Lisdexamfetamine dimesylate as a treatment for ADHD: Dosage formulation and pH effects. Poster presented at the American Psychiatric Association annual meeting, May 19–24, 2007, San Diego
  13. Ermer JC et al. CNS Drug 2010; 24(12): 1009–25
  14. Haffey M et al. Postgrad Med 2009; 121: 11–9
  15. Krishnan S & Zhang Y. J Clin Pharmacol 2008; 48(3): 293–302
  16. Ermer J et al. J Clin Pharmacol 2010; 50(9): 1001–10.
  17. Wigal T et al. Behav Brain Func 2010; 6: 34
  18. Adler LA, et al. J Clin Psychiatry 2013;74(7):694-702
  19. Adler LA, et al. BMC Psychiatry 2013;13:253
  20. Adler LA et al. J Clin Pyschiatry 2008; 69(9): 1364–73
  21. Wilens TE et al. J Clin Psychiatry 2009; 70(11): 1557–62.
  22. Isquith PK, et al. BRIEF Interpretative Report. Available at: documents.acer.org/sample_reports/brief-interpretive.pdf (accessed May 2019)

This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Adverse events should be reported. Reporting forms and information can be found at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Shire Pharmaceuticals Ltd at drugsafety@shire.com

Job Code: C-APROM/UK//2853

Date of Preparation: May 2019

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