Format

Send to

Choose Destination
Chest. 2019 Feb;155(2):364-374. doi: 10.1016/j.chest.2018.11.005. Epub 2018 Nov 22.

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

Author information

1
From the University of Pittsburgh/Veterans Administration Pittsburgh Health System, Pittsburgh, PA. Electronic address: strollopj@upmc.edu.
2
Sahlgrenska University Hospital, Gothenberg University, Gothenberg, Sweden.
3
Emory Sleep Center, Emory University, Atlanta, GA.
4
PAB Clinical Research/Florida Sleep Disorder Center, Brandon, FL.
5
Jazz Pharmaceuticals plc, Palo Alto, CA.
6
Jazz Pharmaceuticals plc, Palo Alto, CA; University of Arkansas for Medical Sciences, Little Rock, AR.
7
Jazz Pharmaceuticals plc, Palo Alto, CA; Stanford University Center for Sleep Sciences and Medicine, Redwood City, CA.
8
INSERM U1042, Grenoble Alpes University Hospital, Grenoble, France.
9
Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

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.

KEYWORDS:

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

PMID:
30471270
DOI:
10.1016/j.chest.2018.11.005
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center