Abstract Rationale To investigate the impact of initiating solriamfetol for residual sleepiness under continuous positive airway pressure (CPAP) therapy on CPAP treatment adherence and CPAP termination rates in adults with obstructive sleep apnea syndrome (OSA). Methods Data from the Système National des Données de Santé (SNDS) database, the French national health insurance reimbursement system were analyzed. The SNDS contains comprehensive, individualized, and anonymized data on health spending reimbursements for 99% of all individuals living in France. All OSA patients who received at least one administration of solriamfetol for between 01/09/2021 and 30/06/2023 and who received at least one CPAP reimbursement in the 12 months before the index date of solriamfetol administration were included. A CPAP adherence score was calculated based on the reimbursement levels (pay for performance scheme (P4P)) for this treatment over 4-week periods: score=3 (more than 4 hours per night on average); score=2 (between 2 and 4 hours per night on average) ; score=1 (less than 2 hours per night on average); Patient no longer using CPAP: score=0. For each patient, we calculated the average score over 6 sequences of 4 weeks preceding and following the index date of solriamfetol initiation. A control group from the SNDS CPAP-treated population was matched by propensity score to subjects treated with both CPAP and solriamfetol. CPAP therapy termination was defined as the cessation of CPAP reimbursements triggered by the respiratory physician or sleep specialist in charge of follow-up. Results 930 OSA patients initiated on Solriamfetol were included and matched to 8,920 controls using only CPAP. The characteristics of the cases and controls were similar (age=56.4 and 57.1 years, 64.5% and 64.6% male, and same burden of comorbidities) During the 6 months before and after the initiation of solriamfetol treatment, the mean CPAP adherence score was slightly but significantly higher in the solriamfetol group than in the control group (before: 2.8 vs. 2.6, p 0.0001, after: 2.8 vs. 2.5, p 0.0001, respectively). CPAP termination rates were significantly higher in the CPAP without Solriamfetol group. Conclusion Adherence to CPAP primary treatment of OSA is maintained after solriamfetol initiation. Figure: Proportion of patients maintained on CPAP therapy following initial treatment with Solriamfetol (Sunosi®), compared to a control group. CPAP adherence is shown for Solriamfetol-treated patients (blue) and controls (red). This abstract is funded by: Pharmanovia
Pepin et al. (Fri,) studied this question.
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