Evidence map›Paper›PMID 39306601›Full record

Trial reportCNS drugs2024

Modafinil Versus Amphetamine-Dextroamphetamine For Idiopathic Hypersomnia and Narcolepsy Type 2: A Randomized, Blinded, Non-inferiority Trial.

Lynn Marie Trotti, Tyler Blake, Romy Hoque, David B Rye, Surina Sharma, Donald L Bliwise

Registry-linked trialAbstract readRandomized Controlled TrialComparative StudyEquivalence Trial
In one paragraph

Trial report in CNS drugs, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03772314 (Informing Treatment Decisions in the Central Disorders of Hypersomnolence), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03772314 phase2completednot on this map

Informing Treatment Decisions in the Central Disorders of Hypersomnolence: A Pragmatic Clinical Trial of Modafinil Versus Amphetamines

TypeinterventionalSponsorEmory UniversityRan2019 to 2023Enrolled44ConditionsIdiopathic Hypersomnia, Narcolepsy Without CataplexyArmsModafinil, Amphetamine-Dextroamphetamine
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Idiopathic hypersomnia is a 24-hour disorder.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lynn Marie TrottiDepartment of Neurology, Emory University School of Medicine, 12 Executive Park Dr NE, Atlanta, GA, 30329, USA. Lbecke2@emory.edu.ORCID 0000-0003-2329-6847
Tyler BlakeDepartment of Neurology, Emory University School of Medicine, 12 Executive Park Dr NE, Atlanta, GA, 30329, USA.
Romy HoqueDepartment of Neurology, Emory University School of Medicine, 12 Executive Park Dr NE, Atlanta, GA, 30329, USA.
David B RyeDepartment of Neurology, Emory University School of Medicine, 12 Executive Park Dr NE, Atlanta, GA, 30329, USA.
Surina SharmaEmory Healthcare, Emory Sleep Center, Atlanta, GA, USA.
Donald L BliwiseDepartment of Neurology, Emory University School of Medicine, 12 Executive Park Dr NE, Atlanta, GA, 30329, USA.

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Antibiotic-mediated improvements in vigilance: mechanisms of action of clarithromycin in hypersomnia syndromesR01NS111280 · NINDS · EMORY UNIVERSITY · PI TROTTI, LYNN MARIE · 2019 to 2023
$2.2M
American Academy of Sleep Medicine Foundation 191-SR-18NCATS NIH HHS UL1 TR002378NCATS NIH HHS UL1TR002378NINDS NIH HHS R01 NS111280
6 · The paper itself

Abstract

BACKGROUND AND

objectiveAlthough there are several treatments for narcolepsy type 2 and idiopathic hypersomnia, studies that assess amphetamines, symptoms beyond sleepiness, and comparative effectiveness are needed. We performed a randomized, fully blinded, noninferiority trial of modafinil versus amphetamine-dextroamphetamine in these disorders.

methodsForty-four adults were randomized to modafinil or amphetamine-dextroamphetamine, individually titrated to a maximum of modafinil 200 mg twice daily or amphetamine-dextroamphetamine 20 mg twice daily, for 12 weeks. Primary outcome was change in Epworth from baseline to week 12, with a noninferiority threshold of 2 points. Secondary outcomes were (1) patient global impression of change measures of disease severity, sleepiness, sleep inertia, and cognition; (2) change from baseline in Hypersomnia Severity Index; and (3) change from baseline in Sleep Inertia Questionnaire. Adverse events were compared between groups.

resultsEpworth improved 5.0 [± standard deviation (SD) 2.7] points with modafinil and 4.4 (± SD 4.7) with amphetamine-dextroamphetamine; noninferiority of amphetamine-dextroamphetamine was not demonstrated (P = 0.11). Noninferiority of amphetamine-dextroamphetamine was demonstrated for change scores of severity, sleepiness, sleep inertia, Hypersomnia Severity Index, and Sleep Inertia Questionnaire. Dropouts due to adverse events were 31.8% for modafinil (including two severe events) and 9.1% for amphetamine-dextroamphetamine, P = 0.13. Anxiety was more common with modafinil and appetite suppression with amphetamine-dextroamphetamine.

conclusionNoninferiority of amphetamine-dextroamphetamine to modafinil was not demonstrated for the primary outcome. However, amphetamine-dextroamphetamine was noninferior on multiple secondary measures of disease severity and symptomatology. These data may inform shared decision-making regarding treatment for idiopathic hypersomnia and narcolepsy type 2. REGISTRATION: Clinicaltrials.gov Registration (NCT03772314) 12/10/18. .

Indexed as

Central Nervous System StimulantsDextroamphetamineModafinilNarcolepsyAdultAmphetamineBenzhydryl CompoundsDouble-Blind MethodFemaleHumansIdiopathic HypersomniaMaleMiddle AgedSeverity of Illness IndexTreatment OutcomeWakefulness-Promoting AgentsAmphetamineBenzhydryl CompoundsCentral Nervous System StimulantsDextroamphetamineModafinilWakefulness-Promoting Agents

Identifiers

PMID39306601
PMCPMC12598845

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.