Other drugs in the pipeline aim to improve on already existing strategies. Thorpy said the drug marks the first time a drug has been designed to manipulate histamine to impact sleep. Pitolisant, meanwhile, uses a different type of strategy, synthesizing and increasing the release of the neurotransmitter histamine. The drug is manufactured by Jazz Pharmaceuticals, which provided funding for the review article. Thorpy said it’s generated significant interest, in part because it can treat excessive daytime sleepiness in patients with obstructive sleep apnea syndrome, an increasingly common disorder. Solriamfetol is a dopamine and norepinephrine reuptake inhibitor. The 2 newly approved drugs are solriamfetol (sold as Sunosi) and pitolisant (marketed as Wakix). He also highlighted that existing treatments tend to have significant side effects, including the risk of abuse. “Even with optimal treatment, these patients are still impaired, so there’s still a need to go further.” “It’s very hard to treat narcolepsy,” said Thorpy. Thorpy noted that while there have long been narcolepsy treatments available on the market, they aren’t sufficient to actually cure the disorder. “And the thing is that the companies are targeting the most severe form of sleepiness that we’re aware of, and the most specific form, narcolepsy.” “There is heightened awareness from the public’s point of view about the importance of sleep,” said Thorpy. Thorpy said that scientific work has coincided with increased public awareness of sleep-related conditions. As a result, they’ve spent the past 2 decades attempting to find ways to compensate for that deficiency. In the case of narcolepsy, scientists have figured a lack of hypocretin. Sleepiness broadly speaking can be caused by a wide range of things, from circadian-rhythm issues like jet lag to chemical deficiencies. “There’s better understanding about how widespread the problem of sleepiness is in society and also we now have a better understanding of the underlying pathophysiology of narcolepsy,” said Thorpy. In an interview with The American Journal of Managed Care ®, Thorpy said that new scientific advances are making narcolepsy an attractive therapeutic area for drug developers. Thorpy, MD, ChB, director of the Sleep-Wake Medical Disorders Center at Montefiore Medical Center, examines the pipeline and its implications for patient care. In a report published last month in CNS Drugs, Michael J. Two new therapies were approved last year for the treatment of narcolepsy and excessive daytime sleepiness, and 4 more are in either phase 2 or 3 trials. The landscape of narcolepsy treatment is changing rapidly and will continue to evolve in the coming years if drugs currently in the research pipeline are eventually approved by regulators.
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