Once-Nightly Treatment for Narcolepsy May Improve Adherence, Ease Stress

Given the choice between once-nightly or twice-nightly sodium oxybate, patients with narcolepsy were significantly more likely to prefer the once-nightly option, according to study findings published in Patient Preference and Adherence.

“Current US Food and Drug Administration (FDA)-approved treatments for narcolepsy include sodium oxybate and calcium, magnesium, potassium, and sodium oxybates (mixed-salt oxybates), which require 2 nightly doses, 1 at bedtime and another 2.5 to 4 hours later,” wrote researchers. “Once-nightly sodium oxybate (FT218) is under FDA review to treat adults with narcolepsy.”

The study was based on a web-based survey of 75 adults with narcolepsy: 50 were current users of twice-nightly sodium oxybate, and 25 had used twice-nightly sodium oxybate in the past. The survey evaluated preferences for sodium oxybate treatment via 20 hypothetical product profiles combining various aspects of once-nightly and twice-nightly options.

Patients provided input into their preferred product overall, which product they would be most likely take as directed, and which product would be less stressful for them to take.

Dosing frequency was the most important driver of product preference, of taking the medication as directed, and of reducing anxiety and stress around taking the medication, according to study authors. Once-nightly dosing was significantly preferred over twice-nightly dosing.

The most common reasons for overall product preference were not needing to wake in the middle of the night for a second dose, fewer side effects, and ease of administration, showed study findings.

“Given the burden of this chronic condition on patients, reducing the dosing frequency has the potential to improve adherence to the prescribed regimen and decrease the stress and anxiety associated with having to take a second, middle-of-the-night dose,” wrote researchers. “This hypothesis was supported by the results of the discrete choice experiment, in which the number of doses (1 vs 2) was identified as the most important overall driver of patient preference.”

Reference:
Dubow J, Avidan AY, Corser B, Athavale A, Seiden D, Kushida C. Preferences for attributes of sodium oxybate treatment: a discrete choice experiment in patients with narcolepsy. Patient Prefer Adherence. 2022;16:937-947. doi:10.2147/PPA.S353412