Del Río-Villegas R, Martínez-Orozco F J, Romero-Santo Tomás O, Yébenes-Cortés M, Gómez-Barrera M, Gaig-Ventura C
Hospitales Vithas, Madrid, España.
Hospital Clínico San Carlos, 28040 Madrid, España.
Rev Neurol. 2022 Oct 1;75(7):165-171. doi: 10.33588/rn.7507.2022090.
Type 1 narcolepsy is a disabling disease that requires continuous treatment, which is not always effective. Pitolisant is a new drug with a different mechanism of action that offers a new treatment option. The objective of the study was to analyse the effectiveness and safety of pitolisant in patients with type 1 narcolepsy that did not respond to or tolerate previous standard treatments.
Real-life multicentre descriptive observational study that included patients diagnosed with type 1 narcolepsy who did not respond to or tolerate previous treatments and started treatment with pitolisant. The study evaluated three different moments: the start of treatment, the stabilization of treatment with pitolisant and the three months after.
In 32 patients included (mean age, 44 years; 37.5% women) the mean of the Epworth Sleepiness Scale was reduced from 17.1 to 13.5; 47.8% of the patients improved from their cataplexy; 65% of the patients improved their clinical global impression at the physician's and at the patient's discretion and the mean number of medications consumed was reduced from 2.0 to 1.4. The most frequent adverse effect was insomnia in 43.8% of patients. Of the 32 patients, 23 continued with the treatment during the 3-month follow-up period.
In patients with type I narcolepsy who do not respond to or do not tolerate the available treatments, pitolisant can improve their clinical situation and reduce their medication consumption. Studies with a higher level of evidence are needed to confirm these results.
1型发作性睡病是一种致残性疾病,需要持续治疗,但治疗效果并非总是有效。匹托酯是一种作用机制不同的新药,提供了一种新的治疗选择。本研究的目的是分析匹托酯在对先前标准治疗无反应或不耐受的1型发作性睡病患者中的有效性和安全性。
一项真实生活的多中心描述性观察性研究,纳入了被诊断为1型发作性睡病且对先前治疗无反应或不耐受并开始使用匹托酯治疗的患者。该研究评估了三个不同阶段:治疗开始时、匹托酯治疗稳定时以及之后的三个月。
纳入的32例患者(平均年龄44岁;37.5%为女性),爱泼沃斯思睡量表评分均值从17.1降至13.5;47.8%的患者猝倒症状有所改善;65%的患者根据医生和患者的判断,临床整体印象有所改善,且平均用药数量从2.0降至1.4。最常见的不良反应是43.8%的患者出现失眠。32例患者中,23例在3个月的随访期内继续接受治疗。
对于对现有治疗无反应或不耐受的1型发作性睡病患者,匹托酯可改善其临床状况并减少用药量。需要更高证据水平的研究来证实这些结果。