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Sunosi for excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea, FDA approved


The FDA ( U.S. Food and Drug Administration ) has approved Sunosi ( Solriamfetol ) to improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea ( OSA ).
Once-daily Sunosi is approved with doses of 75 mg and 150 mg for patients with narcolepsy and doses of 37.5 mg, 75 mg, and 150 mg for patients with obstructive sleep apnea.
Sunosi is the first dual-acting dopamine and norepinephrine reuptake inhibitor ( DNRI ) approved to treat excessive daytime sleepiness in adults living with narcolepsy or obstructive sleep apnea.

At Week 12, 150 mg of Solriamfetol for narcolepsy patients and all doses for OSA patients demonstrated improvements in wakefulness compared to placebo as assessed in test sessions 1 ( approximately one hour post-dose ) through 5 ( approximately nine hours post-dose ) of the maintenance of wakefulness test ( MWT ).

The FDA's approval of Sunosi is based on data from the TONES ( Treatment of Obstructive sleep apnea and Narcolepsy Excessive Sleepiness ) phase 3 clinical program, which included four randomized placebo-controlled studies that demonstrated the superiority of Solriamfetol relative to placebo.

The most common adverse reactions ( incidence 5% and higher than placebo ) reported in both the narcolepsy and OSA study populations were headache, nausea, decreased appetite, and anxiety.

Sunosi was evaluated in more than 900 adults with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea and was shown to maintain its effect relative to placebo after six months of use.

In 12 week clinical studies, approximately 68-74% of people taking Sunosi at the 75 mg dose and 78-90% of people taking Sunosi at the 150 mg dose reported improvement in their overall clinical condition, as assessed by the Patient Global Impression of Change ( PGIc ) scale.

Although the exact mechanism of action is unknown, the effects of Sunosi are thought to be mediated through its activity as a DNRI.

Sunosi is not indicated to treat the underlying airway obstruction in OSA. Ensure that the underlying airway obstruction is treated ( e.g., with continuous positive airway pressure [ CPAP] ) for at least one month prior to initiating Sunosi for excessive daytime sleepiness in OSA.
Modalities to treat the underlying airway obstruction should be continued during treatment with Sunosi. Sunosi is not a substitute for these modalities.( Xagena )

Source: Jazz Pharmaceuticals, 2019

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