lemborexant治疗合并症失眠的安全性和实际疗效

Q1 Medicine

Sleep Medicine: X Pub Date : 2023-03-27 DOI:10.1016/j.sleepx.2023.100070

Narimasa Katsuta, Keitaro Takahashi, Yui Kurosawa, Akane Yoshikawa, Yoshihide Takeshita, Yoshihiro Uchida, Seita Yasuda, Chihiro Kakiuchi, Masanobu Ito, Tadafumi Kato

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引用次数: 0

摘要

目的研究乐莫沙治疗与其他精神疾病相关的共病性失眠的真实有效性和安全性，方法对2020年4月至2021年12月期间由Juntendo大学医院精神诊所医生治疗的门诊和住院患者进行回顾性观察研究。约64.5%的患者被归类为应答组。大多数精神疾病的有效率≥60%。在给药lemborexant后，参与者中BZs的地西泮等效剂量显著降低（3.7±8.2 vs.2.9±7.9，p<；0.001）。逻辑回归分析结果显示，门诊患者（比值比：2.310；95%置信区间[CI]：1.32–4.05）、，无不良事件（比值比：10.369；95%可信区间：6.13-17.54），在引入lemborexant处方后，BZs的地西泮等效剂量减少幅度更大（比值比为：1.150；95%置信区间：1.04-1.27），suvorexant为替代药物（比值比2.983；95%可信范围：1.44-6.19），这些都是良好反应的重要预测因素。结论尽管这是一项具有许多局限性的回顾性和观察性研究，但我们的研究结果表明，雷博瑞吨是有效和安全的。

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Safety and real-world efficacy of lemborexant in the treatment of comorbid insomnia

Aim

To investigate the real-world effectiveness and safety of lemborexan for treating comorbid insomnia associated with other psychiatric disorders, and whether lemborexant helps reduce the dose of benzodiazepines (BZs).

Methods

This retrospective observational study was conducted on outpatients and inpatients treated by physicians of Juntendo University Hospital Mental Clinic between April 2020 and December 2021.

Results

Data of 649 patients who were treated with lemborexant were eventually enrolled. About 64.5% of patients were classified as the responder group. Response rates of ≥60% were recorded for most psychiatric disorders. Upon administration of lemborexant, diazepam-equivalent dose of BZs had been significantly reduced in participants (3.7 ± 8.2 vs. 2.9 ± 7.9, p < 0.001). The results of logistic regression analysis showed that outpatient (odds ratios: 2.310; 95% confidence interval [CI]: 1.32–4.05), shorter duration of BZ use (<1 year) (odds ratios: 1.512; 95% CI: 1.02–2.25), no adverse events (odds ratios: 10.369; 95% CI: 6.13–17.54), larger reduction of diazepam-equivalent dose of BZs upon introducing lemborexant prescription (odds ratios: 1.150; 95% CI: 1.04–1.27), and suvorexant was the replacement drug (odds ratios: 2.983; 95% CI: 1.44–6.19), which were significant predictors of good response.