NeurologyAdvisor: Cardiovascular risk profiles should be taken into account when weighing risk modification strategies and making treatment decisions for patients with narcolepsy, according to study results presented at the 2022 American Academy of Neurology (AAN) Annual Meeting.

Narcolepsy is a rare disorder of hypersomnolence which requires long-term treatment. Patients with narcolepsy often have comorbidities and many treatment labels for the condition have cardiovascular-related precautions and warnings. The objective of the current study was to evaluate the overall cardiovascular burden among adult patients with narcolepsy.

Researchers from Jazz Pharmaceuticals and Aetion Inc sourced data for this study from the IBM MarketScan database. Between 2014 and 2019, patients (N=54,239,110) aged 18 years and older who had continuous medical and prescription coverage were matched in a 3:1 ratio with patients who had 2 or more outpatient claims containing a narcolepsy type one or two diagnosis. The rate of relevant comorbidities was evaluated among the patients with narcolepsy (n=12,816) and matched control individuals (n=38,441).

Among both cohorts, approximately 67% were women and the average age was approximately 38 years.

Compared with control individuals, patients with narcolepsy were associated with increased rates of stroke (hazard ratio [HR], 1.71; 95% CI, 1.24-2.34; P <.05); ischemic stroke (HR, 1.67; 95% CI, 1.19-2.34; P <.05); edema (HR, 1.61; 95% CI, 1.28-2.03; P <.05); major adverse cardiac events (HR, 1.45; 95% CI, 1.20-1.74; P <.05); heart failure (HR, 1.35; 95% CI, 1.03-1.76; P <.05); any cardiovascular disease excluding hypertension (HR, 1.30; 95% CI, 1.08-1.56; P <.05); and the composite outcome of stroke, atrial fibrillation, or edema (HR, 1.48; 95% CI, 1.25-1.74; P <.05).

This study may have included coding errors and some conditions may have been unaccounted for due to undercoding.

These data indicated that the population of patients with narcolepsy disease had greater cardiovascular burden compared with the general population. As many therapies for narcolepsy have cardiovascular-related warnings on their labels, “physicians should consider increased cardiovascular risk when weighing risk modification strategies and treatment options for narcolepsy,” the researchers concluded.

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