Guanfacine for Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and/or Oppositional Defiance Disorder


( Last Updated : July 27, 2022)
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1440-000

Details


Question

  1. What is the clinical effectiveness of guanfacine versus psychostimulant drugs for attention-deficit/ hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?
  2. What is the clinical effectiveness of guanfacine versus other non-psychostimulant drugs for attention-deficit/hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?
  3. What is the clinical effectiveness of guanfacine versus placebo or no therapy for attention-deficit/hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?
  4. What is the cost-effectiveness of guanfacine versus psychostimulant drugs for attention-deficit/hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?
  5. What is the cost-effectiveness of guanfacine versus other non-psychostimulant drugs for attention-deficit/hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?
  6. What is the cost-effectiveness of guanfacine versus placebo or no therapy for attention-deficit/hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?
  7. What are the evidence-based guidelines regarding the use of guanfacine for attention-deficit/hyperactivity disorder, autism spectrum disorder, and oppositional defiance disorder?

Key Message

This review identified 4 relevant systematic reviews, 2 randomized controlled trials and 1 guideline since 2017.

The systematic reviews and trials suggest that guanfacine is more clinically effective than placebo for improving symptoms of attention-deficit/ hyperactive disorder, however it may be associated with increased adverse events such as abdominal pain and fatigue.

There is some suggestion from 2 systematic reviews that guanfacine may be equally effective as other psychostimulants or non-psychostimulants, with the potential for more greater side effects, but the evidence is highly uncertain.

The included guideline has a strong recommendation to offer guanfacine for use in children and adolescents when psychostimulants have failed, or they are not tolerable.

No evidence was identified on the cost-effectiveness of guanfacine relative to psychostimulants, non-psychostimulants or placebo that met the inclusion criteria.