Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC 27705, USA; Pharmacy Service, Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC 27705, USA.
Pharmacy Service, Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC 27705, USA.
J Crit Care. 2020 Oct;59:1-5. doi: 10.1016/j.jcrc.2020.05.006. Epub 2020 May 20.
To assess the efficacy and safety of suvorexant for the prevention of delirium during acute hospitalization.
Pubmed (1946 to December 2019) and Embase (1947 to December 2019) were queried using the search term combination: delirium, confusion, cognitive defect, encephalopathy, critically ill patient, critical illness, or hospitalization and suvorexant or orexin receptor antagonist. Studies analyzed for relevance evaluated clinical outcomes of patients treated with suvorexant for prevention of delirium. Studies appropriate to the objective were evaluated, including two randomized controlled trials and four retrospective studies.
In acutely hospitalized patients, treatment with suvorexant 15 to 20 mg alone or in combination with ramelteon resulted in a reduction in development of delirium, time until delirium onset, and length of hospital stay. When assessed, suvorexant was well tolerated and adverse effects were no worse than placebo.
Based on the reviewed literature, suvorexant has shown positive outcomes in the prevention of delirium during an acute hospitalization. Larger trials comparing the efficacy of suvorexant to other sleep modulating options are necessary to further delineate its role for the prevention of delirium.
评估苏沃雷生预防急性住院期间谵妄的疗效和安全性。
通过使用以下搜索词组合在 Pubmed（1946 年至 2019 年 12 月）和 Embase（1947 年至 2019 年 12 月）上进行查询：谵妄、意识混乱、认知缺陷、脑病、重症患者、危重病、住院和苏沃雷生或食欲素受体拮抗剂。分析相关性的研究评估了接受苏沃雷生治疗预防谵妄的患者的临床结局。评估了符合目标的研究，包括两项随机对照试验和四项回顾性研究。
在急性住院患者中，单独使用苏沃雷生 15 至 20 毫克或与雷美替胺联合使用可降低谵妄的发生、谵妄发作时间和住院时间。评估时，苏沃雷生耐受性良好，不良反应与安慰剂无差异。
根据已审查的文献，苏沃雷生在预防急性住院期间谵妄方面显示出积极的结果。需要更大规模的试验来比较苏沃雷生与其他睡眠调节选择的疗效，以进一步确定其在预防谵妄方面的作用。
