Polytherapy Increases Patient-Centered Management of Narcolepsy Symptoms

Polytherapy may increase the possibility of patient-centered management of narcolepsy symptoms due to the increasing number of pharmacological options, according to study authors.

“Our study presents the picture of a large cohort of Italian patients with narcolepsy who were prescribed with pitolisant, suggesting that polytherapy is highly frequent to tailor a patient-centered approach,” wrote researchers.

Researchers assessed a large cohort of Italian patients with narcolepsy who were candidates for pitolisant treatment and compared patients’ subgroups based on current drug treatment where pitolisant was the first choice, patients switched to pitolisant from other monotherapy treatments, or pitolisant was added as polytherapy.

The cross-sectional survey study was based on data from the Post Authorization Safety Study of pitolisant, which was a 5-year observational, multicenter, international study.

Of the 199 patients enrolled in the study, 76.4% had narcolepsy type 1 and 23.6% had narcolepsy type 2. At least 1 comorbidity, mainly cardiovascular and psychiatric, was present in 63.4% of patients.

In 120 patients (62.8%), pitolisant was prescribed as an add-on treatment; in 42 patients (22%) it was a switch from other therapies; and in 29 patients (15.2%) it was a first-line treatment.

More severe sleepiness, lower functional status, and a higher incidence of depressive symptoms were present in drug-naïve patients.

Researchers concluded that further studies will clarify, and possibly support, the appropriateness of prescription choice and the efficacy and safety of pitolisant as a polytherapy option in a real-world setting.

Reference:
Mutti C, Brunetti V, Figorilli M, et al. Clinical characteristics of a large cohort of patients with narcolepsy candidate for pitolisant: a cross-sectional study from the Italian PASS Wakix cohort. Neurol Sci. Published online June 25, 2022. doi:10.1007/s10072-022-06210-9