Neurology:拮抗食欲素受体 或成为治疗失眠新机制

2012-12-14 Neurology Neurology

  美国学者评估食欲素受体拮抗剂suvorexant治疗原发性失眠效果发现,治疗4周后,非老龄成人的睡眠效率可获显著提高。论文发表于《神经病学》[Neurology2012,79(23):2265]杂志。   研究分2个阶段,每阶段历时4周,患者在第1阶段接受suvorexant 10 mg(n=62)、20 mg(n=61)、40mg(n=59)、80 

  美国学者评估食欲素受体拮抗剂suvorexant治疗原发性失眠效果发现,治疗4周后,非老龄成人的睡眠效率可获显著提高。论文发表于《神经病学》[Neurology2012,79(23):2265]杂志。

  研究分2个阶段,每阶段历时4周,患者在第1阶段接受suvorexant 10 mg(n=62)、20 mg(n=61)、40mg(n=59)、80 mg(n=61),在第2阶段接受安慰剂(n=249)。在每阶段第1晚及结束时行多导睡眠图监测。

  结果为,第4周时,与安慰剂相比,suvorexant可显著改善睡眠效率,且呈剂量相关性(P<0.01),对于睡眠诱导和持续也存在剂量相关性,且患者对其耐受性良好。

失眠相关的拓展阅读:


Objective
To assess the utility of orexin receptor antagonism as a novel approach to treating insomnia.
Methods
We evaluated suvorexant, an orexin receptor antagonist, for treating patients with primary insomnia in a randomized, double-blind, placebo-controlled, 2-period (4 weeks per period) crossover polysomnography study. Patients received suvorexant (10 mg [n = 62], 20 mg [n = 61], 40 mg [n = 59], or 80 mg [n = 61]) in one period and placebo (n = 249) in the other. Polysomnography was performed on night 1 and at the end of week 4 of each period. The coprimary efficacy end points were sleep efficiency on night 1 and end of week 4. Secondary end points were wake after sleep onset and latency to persistent sleep.
Results
Suvorexant showed significant (p values <0.01) dose-related improvements vs placebo on the coprimary end points of sleep efficiency at night 1 and end of week 4. Dose-related effects were also observed for sleep induction (latency to persistent sleep) and maintenance (wake after sleep onset). Suvorexant was generally well tolerated.
Conclusions
The data suggest that orexin receptor antagonism offers a novel approach to treating insomnia.
Classification of evidence
This study provides Class I evidence that suvorexant improves sleep efficiency over 4 weeks in nonelderly adult patients with primary insomnia.
    

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