Characterization of Patients With Narcolepsy Treated vs Not Treated With Sodium Oxybate: A Propensity Score–Matched Cohort Study

This study was funded by Avadel Pharmaceuticals. Introduction: This study used aggregate electronic health record (EHR) data and a natural language processing (NLP) algorithm to characterize demographic characteristics and comorbidities of patients with narcolepsy treated with/without sodium oxybate (SXB). Methods: An EHR-based search identified first-time Mayo Clinic patients between 1975–2020. Patients had ≥1 narcolepsy-specific ICD-9/-10 code and ≥1 diagnostic mention of narcolepsy in clinical notes (NLP). Patients with narcolepsy treated with SXB were age/sex matched with a cohort without SXB. Common comorbidities were identified and compared between cohorts (odds ratio [OR]). Results: 4387 patients with narcolepsy were identified; 8% received SXB treatment (n=351; mean [IQR] age at first diagnosis code observed at Mayo Clinic, 32 [23.2-46.1] y; 65.5% female; 92.3% white) and 4036 patients had no SXB treatment (mean [IQR] age at first diagnosis code observed at Mayo Clinic, 44.8 [29.8-59.0] y; 58.0% female; 88.9% white). The 10 most frequent comorbidities overall were insomnia, fatigue, depression, hypertension, hyperlipidemia, obstructive sleep apnea, diabetes mellitus, arrhythmia, idiopathic hypersomnia (IH), and coronary artery disease. For the age/sex matched cohorts, unadjusted P values were significant for differences between cohorts (OR [95% CI] SXB vs no SXB) for fatigue (0.72 [0.54-0.97]; P0.9) and IH (0.60 [0.43-0.84]; P