A study funded by Avadel Pharmaceuticals, which just launched Lumryz for narcolepsy in the US, describes clinician preferences among oxybate treatments for narcolepsy and highlights a need for once-at-bedtime oxybate dosing. 

Among 100 clinicians, the primary driver of overall oxybate choice, potential to improve patient quality of life, and decrease stress/anxiety was a single bedtime dose over the twice-nightly dosing of first-generation oxybates. The paper was published in Advances in Therapy.

“Sodium oxybate has been recognized as a standard of care to treat narcolepsy for more than 20 years but, until recently, has required two nighttime doses for sufficient therapy. Data published recently demonstrate that clinicians recognize the negative impact of middle-of-the-night dosing required with twice-nightly therapies,” says Anne Marie Morse, DO, director of child neurology and pediatric sleep medicine at Geisinger Medical Center at Janet Weis Children’s Hospital, in a release. “The ability to further consolidate nocturnal sleep and simplify medication regimens is extraordinarily impactful.”

Discrete choice experiments (DCE) are studies designed to characterize and quantify drivers of preferences for attributes. Clinicians selected from hypothetical, randomly generated medicine profiles to determine which medication they preferred overall, which would improve patient quality of life, and which would reduce patient anxiety and stress. Data highlights are outlined below.

Prior to the DCE, a survey to understand perspectives of first-generation, twice-nightly oxybates, and other treatments for narcolepsy, was undertaken. Clinicians reported moderate to high satisfaction with immediate-release oxybate treatments; however, clinicians indicated that twice-nightly dosing was a significant stressor for patients.

  • In the DCE, the frequency of oxybate treatment dosing was the most important driver for overall product choice, improved patient quality of life, and reduced patient anxiety and stress; once-nightly dosing was preferred over twice-nightly.
    • The frequency of oxybate treatment dosing, driven by once-nightly dosing, was more than twice as important for overall product choice than the next two attributes, which were adverse reactions and sodium content, respectively.
    • Similarly, frequency of oxybate treatment dosing, driven by once-nightly dosing, was more than double in relative importance, for patient quality of life and for reducing patient anxiety/stress, than other attributes.
  • This DCE validates a previously published DCE in patients, in which dosing frequency was also shown to be the most important driver of patients’ preferred oxybate treatment.
  • These data underscore the long unmet need for an oxybate treatment that does not require middle-of-the-night dosing.

“We routinely and consistently hear from people living with narcolepsy and clinicians that there is a critical need for an effective therapy to manage cataplexy or excessive daytime sleepiness while allowing for the possibility of an uninterrupted night sleep,” says Jennifer Gudeman, PharmD, senior vice president of medical and clinical affairs of Avadel, in a release. “These data provide insight that the most important driver of oxybate choice is dosing and not sodium content.”

Photo 79135299 © Kiosea39 | Dreamstime.com