Questions Regarding Once-Nightly Sodium Oxybate for Narcolepsy


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Questions raised by a recent paper by Kushida CA, et al., highlighting symptom improvement with once-nightly sodium oxybate in patients with narcolepsy.

Clete Kushida, MD, PhD: So, Lois, what interesting questions did this paper raise?

Lois E. Krahn, MD: Well, for me, there’s a fundamental question, which is “Can a once a night form of this medication work, and is it well tolerated? Is it safe?” And I greatly appreciate that this data is now available, that we all can look at it because, in my view, the answers are yes. And so, we have more choices for patients, especially those who have life circumstances where awakening part through the night is disruptive to their bed partner. They have disliked that practice if they’ve previously taken the twice a night form of sodium oxybate. And for younger, newer users, where they and their families are just getting used to being on oxybate therapy, learning how to take this medication, the fact that they only need to take it once a night and not worry about a repeat dose, I think will greatly increase their comfort with considering all the necessary preparations to take these medications safely.

Clete Kushida, MD, PhD: Those are perfect points, Lois. One additional question that I had in my mind was about the sleep architecture. That wasn’t something that was addressed within this study, but it would be interesting to look at that the data to see would this once-nightly, sodium oxybate result in more normal sleep architecture compared to twice-nightly dosing.

Lois E. Krahn, MD: I think that that’s very important data, and I hope that it gets attention and is looked at more closely. Because, of course, we all want medications where they make a difference for the patient’s symptoms, but that the levels of the medication in the patient’s body aren’t higher than they need to be and are just released in a more continuous gradual way and come closer to normalizing sleep. That’s what we want for our patients, with all of our therapies and with the once-a-night form of oxybate therapy. The Cmax data is very promising.

Transcript edited for clarity.

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