ArticleNeurology and therapy2026
Narcolepsy and Idiopathic Hypersomnia Real-World Treatment Patterns and Changes in Alerting Agent Use After Low-Sodium Oxybate Initiation: A Retrospective Claims Analysis.
Article in Neurology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionVarious medications are prescribed to treat narcolepsy and idiopathic hypersomnia (IH), including low-sodium oxybate (LXB) and alerting agents (AAs; i.e., stimulants and wake-promoting agents). This study assessed treatment patterns in individuals with narcolepsy/IH, as well as changes in AA utilization following LXB initiation.
methodsOptum
resultsThe narcolepsy cohort included 43,252 individuals (mean [SD] age 42.8 [17.2] years; 62.9% female). In the total and post-LXB (n = 10,220) follow-up periods, 30.9% and 35.3%, respectively, did not receive any treatment of interest. The most frequent first-line treatments were AAs (total follow-up: 52.9%; 76.5% among those treated; post-LXB period: 49.3%; 76.1% among those treated). Among 788 individuals with AA treatment prior to LXB initiation, 42.9% experienced AA discontinuation or reduction following LXB initiation. The IH cohort included 24,528 individuals (mean [SD] age 45.8 [15.7] years; 61.7% female). In the total and post-LXB (n = 2971) follow-up periods, 54.1% and 50.3%, respectively, did not receive any treatment of interest. The most frequent first-line treatments were AAs (total follow-up: 31.2%; 67.9% among those treated; post-LXB period: 36.2%; 72.9% among those treated). Among 96 individuals with AA treatment prior to LXB initiation, 53.1% experienced AA discontinuation or reduction following LXB initiation.
conclusionNumerous treatment trajectories were observed after narcolepsy/IH diagnosis, highlighting the complexity in treating these conditions. Many individuals did not receive any treatment over the total follow-up period, which may indicate a treatment gap. AA discontinuation or reduction was common following LXB initiation.
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