pitolisant治疗发作性睡病的授权后安全性研究的中期分析:一项真实的欧洲研究

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY Sleep medicine Pub Date : 2025-05-01 Epub Date: 2025-02-07 DOI:10.1016/j.sleep.2025.02.012
Giuseppe Plazzi , Geert Mayer , Ralf Bodenschatz , Enrica Bonanni , Alessandro Cicolin , Giacomo Della Marca , Pierluigi Dolso , Luigi Ferini Strambi , Raffaele Ferri , Peter Geisler , Svenja Happe , Anna Heidbreder , Jürgen Herold , Ulf Kallweit , Laurène Leclair-Visonneau , Katharina Lederer , Claudio Liguori , Johan Meurling , Liborio Parrino , Paola Proserpio , Yves Dauvilliers
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引用次数: 0

摘要

发作性睡病是一种慢性睡眠障碍,主要表现为白天过度嗜睡(EDS)和1型发作性睡病(NT1)的猝厥。Pitolisant是一种组胺3受体拮抗剂/逆激动剂,可减少发作性睡病患者的EDS和猝倒。方法:我们对NT1和NT2患者进行了一项前瞻性5年随访,非介入性研究。本研究的主要目的是收集有关吡喃唑的长期安全性信息,并分析吡喃唑的使用模式。次要目的是评估临床获益、依从性、对患者生活质量的影响、疾病负担和患者满意度。我们报告了42.6个月后的中期分析结果。结果本组370例患者,平均年龄40±15岁;女性占51.4%;Nt1, 71.4%;Nt2, 28.6%);364例接受了≥1剂量的吡托抗。356例(97.8%)患者可获得数据。大多数患者(68.4%)有≥1种合并症(肥胖[BMI≥30],31.9%;神经精神病学,31%;心血管,22.8%)。48例(13.2%)患者之前没有接受过发作性睡症治疗,而98例(31%)患者之前接受过治疗,后来改用匹妥抗。218例(69%)患者联合吡松坦治疗。131例(35.4%)患者停药,主要是出于安全原因(14.3%)、缺乏反应(8.7%)和患者决定(7.6%)。总体而言,156例患者(占安全人群的42.9%)报告了355例治疗引起的不良事件(3例严重),109例患者(29.9%)报告了218例可能与治疗相关(61.4%)。EDS、猝倒和生活质量均有改善。结论spitolisant在NT1和NT2患者中普遍安全且耐受性良好,可用于两种类型。EDS、猝倒和生活质量均有改善,依从性和满意度良好。
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Interim analysis of a post-authorization safety study of pitolisant in treating narcolepsy: A real-world European study

Background

Narcolepsy is a chronic sleep disorder characterized mainly by excessive daytime sleepiness (EDS) and cataplexy in the case of narcolepsy type 1 (NT1). Pitolisant is a histamine 3 receptor antagonist/inverse agonist that reduces EDS and cataplexy in patients with narcolepsy.

Methods

We performed a prospective 5‐year follow‐up, non‐interventional study of adults with NT1 and NT2 receiving pitolisant. The primary objectives were to collect information on the long-term safety of pitolisant and analyze the utilization patterns of pitolisant. The secondary objectives were to assess clinical benefit, adherence, impact on patients’ quality of life, disease burden, and patient satisfaction. We reported the results of an interim analysis after 42.6 months.

Results

The population comprised 370 patients (mean age, 40 ± 15 years; 51.4 % women; NT1, 71.4 %; NT2, 28.6 %); 364 received ≥1 dose of pitolisant. Data were available for 356 patients (97.8 %).
Most patients (68.4 %) had ≥1 comorbidity (obesity [BMI≥30], 31.9 %; neuropsychiatric, 31 %; and cardiovascular, 22.8 %). Forty-eight patients (13.2 %) had received no prior narcoleptic treatment, while 98 (31 %) were taking a previous therapy, which was switched to pitolisant. Treatment was combined with pitolisant in 218 (69 %) patients. Pitolisant was discontinued by 131 patients (35.4 %), mainly for safety reasons (14.3 %), lack of response (8.7 %), and patient decision (7.6 %). Overall, 355 treatment-emergent adverse events (3 serious) were reported by 156 patients (42.9 % of safety population), with 218 possibly treatment-related (61.4 %) in 109 patients (29.9 %). Improvements were observed in EDS, cataplexy, and quality of life.

Conclusions

Pitolisant was generally safe and well tolerated in patients with NT1 and NT2 and can be used in both types. Improvements were found in EDS, cataplexy, and quality of life, with good adherence and satisfaction.
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来源期刊
Sleep medicine
Sleep medicine 医学-临床神经学
CiteScore
8.40
自引率
6.20%
发文量
1060
审稿时长
49 days
期刊介绍: Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.
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