Lemborexant vs suvorexant for insomnia: A systematic review and network meta-analysis

Kishi, Taro; Nomura, Ikuo; Matsuda, Yuki; Sakuma, Kenji; Okuya, Makoto; Ikuta, Toshikazu; Iwata, Nakao

doi:10.1016/j.jpsychires.2020.05.025

Cited by 68 publications

(64 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This NMA examined the efficacy and safety of lemborexant and 15 other insomnia treatments across 45 studies. Only 1 previous limited meta-analysis had included lemborexant, 23 and only included 3 interventions (lemborexant, suvorexant, and zolpidem-ER). The NMA concluded that lemborexant 10 mg had superior efficacy, 23 which is consistent with our more comprehensive finding that lemborexant ranked highest on 3 of the 4 objective measures (TST, LPS, and SE).…”

Section: Discussionmentioning

confidence: 99%

“…Only 1 previous limited meta-analysis had included lemborexant, 23 and only included 3 interventions (lemborexant, suvorexant, and zolpidem-ER). The NMA concluded that lemborexant 10 mg had superior efficacy, 23 which is consistent with our more comprehensive finding that lemborexant ranked highest on 3 of the 4 objective measures (TST, LPS, and SE). In our analysis, the highest-ranked intervention exceeded clinical significance thresholds for mean change relative to placebo proposed by the American Academy of Sleep Medicine for PSG-measured TST, LPS, SE, and WASO, 21 indicating that the results should potentially translate into clinical benefit to patients.…”

Section: Discussionmentioning

confidence: 99%

“…An NMA can thus estimate "indirectly" differences in outcomes between treatments that have never been directly compared, head-to-head, in RCTs. Previous meta-analyses in insomnia have been conducted, [17][18][19][20][21][22][23] however, only 1 included lemborexant, 23 and this compared lemborexant with only 2 other treatments, suvorexant and zolpidem-ER. The objective of this systematic literature review and NMA was to compare lemborexant with 15 specified other insomnia treatments (derived from consultation with physicians) using measures of sleep maintenance, sleep onset, sleep quality, and incidence of adverse events (AEs).…”

Section: What This Study Addsmentioning

confidence: 99%

See 2 more Smart Citations

Comparative efficacy of lemborexant and other insomnia treatments: a network meta-analysis

McElroy¹,

O'Leary²,

Adena³

et al. 2021

JMCP

View full text Add to dashboard Cite

BACKGROUND: Insomnia is a common disorder associated with a substantial burden of illness, particularly in older adults. OBJECTIVE:To compare the efficacy and safety of lemborexant with specified other insomnia treatments through a systematic literature review and network meta-analysis (NMA). METHODS:Medline and Embase were systematically searched from inception to February 2019 and updated with a targeted search of PubMed for pivotal trials in March 2021. Randomized controlled trials in adults with primary insomnia were included if they reported results following at least 1 week of treatment. Interventions of interest were specified as lemborexant, suvorexant, benzodiazepines, benzodiazepine receptor agonists (also called Z-drugs [zolpidem, eszopiclone, zaleplon, zopiclone]),

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

See 1 more Smart Citation

Comparative efficacy of lemborexant and other insomnia treatments: a network meta-analysis

McElroy¹,

O'Leary²,

Adena³

et al. 2021

JMCP

View full text Add to dashboard Cite

show abstract

“…19 For suvorexant, the relative risk of somnolence was 2.05-3.53 compared with the placebo in the meta-analysis. [20][21][22] In a double-blind, randomized, crossover study comparing 20mg suvorexant, 10-mg zolpidem, and placebo, electroencephalography (EEG) was performed. 24 After zolpidem administration, the theta-and alpha-wave densities were reduced during the rapid eye movement (REM) sleep and non-REM sleep compared with those after placebo administration in healthy subjects.…”

Section: Suvorexantmentioning

confidence: 99%

Evidence‐based insomnia treatment strategy using novel orexin antagonists: A review

Kishi

Nishida

Koebis

et al. 2021

Neuropsychopharm Rep

Self Cite

View full text Add to dashboard Cite

Insomnia is one of the most common sleep disorders. 1 Approximately 35% of the general population has at least one of the symptoms of insomnia. 2 In addition to nighttime sleep onset and/or maintenance difficulties, the diagnostic criteria for insomnia disorder include daytime dysfunction. Patients with insomnia frequently present with fatigue, daytime sleepiness, and/or difficulties with attention, concentration, and memory. Thus, the treatment goal was to alleviate nighttime sleep difficulties and daytime dysfunction. 3 Nonpharmacological treatments, such as cognitive-behavioral therapy, are initially recommended for patients with chronic insomnia. Although these are effective and vital therapeutic modalities for adult patients, pharmacotherapy might be required when the initial approach is ineffective in terms of

show abstract

“…Indeed, we note that several clinical trials are currently underway examining the efficacy of suvorexant in CUD and AUD populations (ClinicalTrials.gov; (Campbell et al, 2020b;James et al, 2020); it is not clear to what extent these studies will include polydrug use as a key outcome measure. Notably, suvorexant and another recently approved DORA (lemborexant) are hypnotics designed to promote sleep in an insomnia indication (Kishi et al, 2020), thus any studies examining their repurposing for addiction must consider whether the soporific effects of these compounds might be enhanced by concomitant drug use. Indeed, prescribing guidelines for suvorexant lists alcohol use as a contraindication, based on evidence that their combined use has negative effects on tests of reaction time, vigilance, working/episodic memory, postural stability and alertness (Sun et al, 2015).…”

Section: Conclusion and Considerations For Future Studiesmentioning

confidence: 99%

The orexin (hypocretin) neuropeptide system is a target for novel therapeutics to treat cocaine use disorder with alcohol coabuse

et al. 2021

View full text Add to dashboard Cite

An estimated 50-90% of individuals with cocaine use disorder (CUD) also report using alcohol. Cocaine users report co-abusing alcohol to 'self-medicate' against the negative emotional side effects of the cocaine 'crash', including the onset of anxiety. Thus, pharmaceutical strategies to treat CUD would ideally reduce the motivational properties of cocaine, alcohol, and their combination, as well as reduce the onset of anxiety during drug withdrawal. The hypothalamic orexin (hypocretin) neuropeptide system offers a promising target, as orexin neurons are critically involved in activating behavioral and physiological states to respond to both positive and negative motivators. Here, we seek to describe studies demonstrating efficacy of orexin receptor antagonists in reducing cocaine, alcohol-and stress-related behaviors, but note that these studies have largely focused on each of these phenomena in isolation. For orexin-based compounds to be viable in the clinical setting, we argue that it is imperative that their efficacy be tested in animal models that account for polysubstance use patterns. To begin to examine this, we present new data showing that rats' preferred level of cocaine intake is significantly increased following chronic homecage access to alcohol. We also report that cocaine intake and motivation are reduced by a selective orexin-1 receptor antagonist when rats have a history of cocaine + alcohol, but not a limited history of cocaine alone. In light of these proof-of-principle data, we outline what we believe to be the key priorities going forward with respect to further examining the orexin system in models of polysubstance use.

show abstract

Lemborexant vs suvorexant for insomnia: A systematic review and network meta-analysis

Cited by 68 publications

References 20 publications

Comparative efficacy of lemborexant and other insomnia treatments: a network meta-analysis

Comparative efficacy of lemborexant and other insomnia treatments: a network meta-analysis

Evidence‐based insomnia treatment strategy using novel orexin antagonists: A review

The orexin (hypocretin) neuropeptide system is a target for novel therapeutics to treat cocaine use disorder with alcohol coabuse

Contact Info

Product

Resources

About