Solriamfetol for Excessive Daytime Sleepiness in Parkinson's Disease: Phase 2 Proof-of-Concept Trial

Mov Disord. 2021 Oct;36(10):2408-2412. doi: 10.1002/mds.28702. Epub 2021 Jun 30.

Abstract

Background: Solriamfetol is approved (US and EU) for excessive daytime sleepiness (EDS) in narcolepsy and obstructive sleep apnea.

Objectives: Evaluate solriamfetol safety/efficacy for EDS in Parkinson's disease (PD).

Methods: Phase 2, double-blind, 4-week, crossover trial: adults with PD and EDS were randomized to sequence A (placebo, solriamfetol 75, 150, 300 mg/d), B (solriamfetol 75, 150, 300 mg/d, placebo), or C (placebo). Outcomes (safety/tolerability [primary]; Epworth Sleepiness Scale [ESS]; Maintenance of Wakefulness Test [MWT]) were assessed weekly. P values are nominal.

Results: Common adverse events (n = 66): nausea (10.7%), dizziness (7.1%), dry mouth (7.1%), headache (7.1%), anxiety (5.4%), constipation (5.4%), dyspepsia (5.4%). ESS decreased both placebo (-4.78) and solriamfetol (-4.82 to -5.72; P > 0.05). MWT improved dose-dependently with solriamfetol, increasing by 5.05 minutes with 300 mg relative to placebo (P = 0.0098).

Conclusions: Safety/tolerability was consistent with solriamfetol's known profile. There were no significant improvements on ESS; MWT results suggest possible benefit with solriamfetol in PD. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Trial registration: ClinicalTrials.gov NCT03037203.

Keywords: JZP-110; Parkinson's disease; Sunosi; sleep-wake disorders; therapeutics.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carbamates / therapeutic use*
  • Disorders of Excessive Somnolence* / drug therapy
  • Disorders of Excessive Somnolence* / etiology
  • Double-Blind Method
  • Humans
  • Parkinson Disease* / complications
  • Parkinson Disease* / drug therapy
  • Phenylalanine / analogs & derivatives
  • Phenylalanine / therapeutic use*

Substances

  • Carbamates
  • Phenylalanine
  • solriamfetol

Associated data

  • ClinicalTrials.gov/NCT03037203