Literature DB >> 30471270

Solriamfetol for the Treatment of Excessive Sleepiness in OSA: A Placebo-Controlled Randomized Withdrawal Study.

Patrick J Strollo1, Jan Hedner2, Nancy Collop3, Daniel G Lorch4, Dan Chen5, Lawrence P Carter6, Yuan Lu5, Lawrence Lee5, Jed Black7, Jean-Louis Pépin8, Susan Redline9.   

Abstract

BACKGROUND: Excessive sleepiness (ES) is a common symptom of OSA, which often persists despite primary OSA therapy. This phase III randomized withdrawal trial evaluated solriamfetol (JZP-110) for the treatment of ES in adults with OSA.
METHODS: After 2 weeks of clinical titration (n = 174) and 2 weeks of stable dose administration (n = 148), participants who reported improvement on the Patient Global Impression of Change (PGI-C) and had numerical improvements on the Maintenance of Wakefulness Test (MWT) and Epworth Sleepiness Scale (ESS) were randomly assigned to placebo (n = 62) or solriamfetol (n = 62) for 2 additional weeks. Coprimary end points were change from weeks 4 to 6 in MWT and ESS.
RESULTS: In the modified intention-to-treat population (n = 122), MWT mean sleep latencies and ESS scores improved from baseline to week 4 (from 12.3-13.1 to 29.0-31.7 minutes and from 15.3-16.0 to 5.9-6.4, respectively). From weeks 4 to 6, participants treated with solriamfetol maintained improvements (least squares [LS] mean [SE] changes of -1.0 [1.4] minutes on MWT and -0.1 [0.7] on ESS), whereas participants treated with placebo worsened (LS mean [SE] change of -12.1 [1.3] minutes on MWT and 4.5 [0.7] on ESS); LS mean differences between treatments were 11.2 minutes (95% CI, 7.8-14.6) and -4.6 (95% CI, -6.4 to -2.8) on MWT and ESS, respectively. Fewer participants treated with solriamfetol reported worsening on the PGI-C from weeks 4 to 6 (20% vs 50%; P = .0005). Common adverse events included headache, dry mouth, nausea, dizziness, and insomnia.
CONCLUSIONS: This study demonstrated maintenance of solriamfetol efficacy and safety over 6 weeks. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT02348619; URL: www.clinicaltrials.gov; EudraCT No.: 2014-005515-16.
Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  JZP-110; OSA; TONES 4; excessive sleepiness; obstructive sleep apnea; solriamfetol

Mesh:

Substances:

Year:  2018        PMID: 30471270     DOI: 10.1016/j.chest.2018.11.005

Source DB:  PubMed          Journal:  Chest        ISSN: 0012-3692            Impact factor:   9.410


  17 in total

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Authors:  Atul Malhotra; Colin Shapiro; Jean-Louis Pepin; Jan Hedner; Mansoor Ahmed; Nancy Foldvary-Schaefer; Patrick J Strollo; Geert Mayer; Kathleen Sarmiento; Michelle Baladi; Patricia Chandler; Lawrence Lee; Richard Schwab
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10.  Effects of solriamfetol in a long-term trial of participants with obstructive sleep apnea who are adherent or nonadherent to airway therapy.

Authors:  Paula K Schweitzer; Kingman P Strohl; Geert Mayer; Russell Rosenberg; Patricia Chandler; Michelle Baladi; Lawrence Lee; Atul Malhotra
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