SURWEY Study of Solriamfetol: Initiation, Titration, Safety, Efficacy, and Follow-Up Experience for Patients with OSA in Germany

This study was funded by Axsome Therapeutics and Jazz Pharmaceuticals. This presentation was supported by Axsome Therapeutics and Pharmanovia. Introduction: Solriamfetol (Sunosi®) is a wake-promoting agent approved to treat excessive daytime sleepiness (EDS) associated with obstructive sleep apnea (OSA) (37.5–150 mg/day). This real-world study characterizes dosing/titration strategies among physicians and patient outcomes. Methods: SURWEY was a retrospective chart review by German physicians in 83 OSA patients. Eligible patients (≥18 years old, diagnosed with EDS due to OSA, reached stable Solriamfetol dose, completed ≥6 weeks of treatment) were classified as changeover (switched from existing EDS medication[s]), add-on (added to current EDS medication[s]), or new-to-therapy (no current EDS medication). Efficacy measures included the Epworth Sleepiness Scale (ESS; 2-3 points represents a minimally clinically important difference), as well as patient- and physician- reported perceptions of improvement. Results: Patients’ mean±SD age was 49±14 years and 65% were male; all used primary airway therapy. New-to-therapy was the most common initiation strategy (n=62). Across subgroups, mean ESS scores at initiation and follow-up ranged from 15.9–16.6 and 10.4-12.2, with mean decreases from 5.3–5.7 points. Improvements in EDS were reported for most (patient-reported, 90%; physician-reported, 89%). Most patients reported solriamfetol effects lasting ≥6 hours (74%) with no change in night-time sleep quality (91%). Common adverse effects were headache, insomnia, and irritability. Conclusions: These real-world data describe Solriamfetol use in German OSA patients. Solriamfetol was typically initiated at 37.5 mg/day; titration was common. ESS improvements were greater than the minimum clinically important difference of 2-3, and most patients and physicians perceived improvement in EDS. Common adverse events were consistent with those previously reported for solriamfetol.