Evidence map›Paper›PMID 41233821›Full record

SynthesisBMC neurology2025

Comparative efficacy of new wake-promoting agents for narcolepsy-a network meta-analysis.

Zian Yan, Jiwei Li, Yixin Yu, Shenghan Qiu, Bing Wang, Jiyou Tang

Abstract readComparative StudySystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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.

Zian YanDepartment of Neurology, the First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan, 250000, Shandong, China.
Jiwei LiDepartment of Neurology, the First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan, 250000, Shandong, China.
Yixin YuDepartment of Neurology, the First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan, 250000, Shandong, China.
Shenghan QiuDepartment of Neurology, the First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan, 250000, Shandong, China.
Bing WangDepartment of Neurology, the First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan, 250000, Shandong, China.
Jiyou TangDepartment of Neurology, the First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan, 250000, Shandong, China. tangjy0920@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs a rare sleep disorder, narcolepsy is treated with various therapeutic options. This article systematically analyzes the efficacy and safety of novel approved wake-promoting drugs.

methodsRandomized controlled trials (RCTs) for patients with narcolepsy and treated with approved interventions were searched. Outcome measures included Epworth sleepiness scale (ESS) score, mean latency in the maintenance of wakefulness test (MWT), cataplexy frequency, number of subjects with ESS scores < 10, standard deviation of lane position (SDLP) score, and adverse events (including anxiety, dizziness). This paper was registered in INPLASY (INPLASY2024120052).

resultsThe final analysis included 13 RCTs with four drugs involved: modafinil/armodafinil, sodium oxybate (SXB), pitolisant, and solriamfetol, at different dosages or combinations. All drugs were effective in treating narcolepsy compared to placebo. Solriamfetol 300 mg was more effective than other treatments in reducing ESS scores (MD =  -4.74, 95%CI: -6.51,-2.97) and prolonging sleep latency (MD = 10.82 min, 95%CI: 6.99, 14.31). Several novel wake-promoting drugs did not show significant differences in improving cataplexy frequency, the number of people with ESS scores < 10, and SDLP scores. The novel wake-promoting drugs compared in this article could improve adverse effects, but some drugs showed an elevated likelihood of some adverse effects compared to controls or other drugs. Compared to placebo, SXB yielded the highest risk of gastrointestinal adverse effects such as diarrhea [8.53, (1.14,263)] and vomiting [29.5, (2.46,1.46e+03)], pitolisant induced the highest risk of nausea [4.22e+08, (4.09,1.26e+32)], and SXB+modafinil had the highest risk of dizziness [7.67, (1.01,58.7)]. There were no considerable differences among drugs in other adverse effects.

conclusionAll of the approved new wake-promoting drugs are effective in controlling narcolepsy symptoms with acceptable adverse effects. Trial Registration The study was prospectively registered in the INPLASY database (INPLASY2024120052).

Indexed as

NarcolepsyWakefulness-Promoting AgentsBenzhydryl CompoundsCarbamatesHumansModafinilPhenylalaninePiperidinesRandomized Controlled Trials as TopicSodium OxybateTreatment OutcomeBenzhydryl CompoundsCarbamatesModafinilPhenylalaninePiperidinespitolisantSodium OxybatesolriamfetolWakefulness-Promoting AgentsEpworth sleepiness scaleNarcolepsyPitolisantSodium oxybateSolriamfetol

Identifiers

PMID41233821
PMCPMC12613485

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.