0970 Real-world Use of Solriamfetol for Excessive Daytime Sleepiness in Patients Reporting Anxiety or Depression

Abstract Introduction Psychiatric comorbidities are common in patients with excessive daytime sleepiness (EDS) from narcolepsy or obstructive sleep apnea (OSA). Real-world efficacy and safety data of wake promoting agents in these populations is limited. Solriamfetol (Sunosi®), a dopamine/norepinephrine reuptake inhibitor that activates TAAR1 and 5HT1A receptors, is approved to treat EDS associated with narcolepsy or OSA. Solriamfetol clinical trials excluded and the prescribing information caution against use in patients with severe psychiatric comorbidities, so limited data exists for this population. Here we describe real world use of solriamfetol in German patients with narcolepsy or OSA who self-reported depression/anxiety (yes/no response) at baseline. Methods We performed a retrospective chart review (SURWEY) using data from German physicians who prescribed solriamfetol to patients with EDS associated with narcolepsy or OSA and at a stable dose for ≥6 weeks. Comorbidities, including anxiety/depression, were documented with background information at baseline. Results Of the 154 patients, n=48 (31.2%) reported anxiety and/or depression (OSA, n=23/83 27.7%, narcolepsy, n=25/71 35.2%). Most patients (≥85%) reported no additional psychiatric, neurological, or sleep disorder. Regardless of primary etiology, baseline mean±SD Epworth Sleepiness Scale (ESS) scores were generally similar in patients with (OSA, 16.0±2.8; narcolepsy, 17.9±3.6) and without (OSA, 16.0±3.3; narcolepsy, 17.5±2.9) anxiety/depression. Overall, mean±SD decreases in ESS scores were 4.6±3.2 and 5.2±3.6 with and without anxiety/depression, respectively; and similar in OSA (5.2±3.1 vs 5.5±3.9), narcolepsy (3.9±3.2 vs 4.9±3.3). Ninety percent of patients achieved ≥2-point reduction in ESS scores from baseline and patients (≥89%) and physicians (≥91%) reported improvement in EDS with solriamfetol, which were both similar across primary etiologies and anxiety/depression presence. Anxiety/depression data was not collected at follow-up. Common adverse events were headache, insomnia, and decreased appetite, which generally occurred at similar rates regardless of reported anxiety/depression. Conclusion These real-world data describe solriamfetol treatment outcomes in narcolepsy or OSA patients who did and did not self-report anxiety/depression. Regardless of anxiety/depression, ESS scores improved, and most patients and physicians reported improved EDS. Our findings are consistent with clinical trial results and suggest that solriamfetol is effective in managing EDS symptoms in this population regardless of common psychiatric comorbidities. Support (if any) Axsome Therapeutics, Jazz Pharmaceuticals, Pharmanovia