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Daridorexant, as the first Dual Orexin Receptor Antagonist (DORA) marketed in Europe, offers a novel therapeutic approach to insomnia. However, data regarding its real-world safety are scarce. Thus, the aim of this study was to assess its safety profile using a large-scale pharma-covigilance database. Daridorexant-related Adverse Drug Reaction (ADR) reports from the FDA Adverse Event Reporting System were scrutinized, and ADRs were selected using reporting odds ratio (ROR) as a measure of disproportionality. Frequencies of events related to daridorexant were compared to all other drugs (reference group, RG1) and only to other DORAs (RG2). Only significant disproportionalities to both RGs were evaluated in-depth. A total of 845 dari-dorexant-related reports were selected; nightmares (n = 146; Dari vs. RG1: ROR = 113.74; 95%CI95.13, 136; Dari vs. RG2: ROR = 2.35; 95CI%1.93, 2.85), depression (n = 22; Dari vs. RG1: 2.13; 1.39, 3.25; Dari vs. RG2: ROR = 2.31; 95CI%1.45, 3.67), and hangover (n = 20; Dari vs. RG1: ROR = 127.92; 95CI%81.98, 199.62; Dari vs. RG2: 3.38; 2.04, 5.61) were considered as safety signals. These data provide valuable insights into the real-world safety profile of dari-dorexant, supporting the existence of safety signals related to nightmares, depression, and hang-over.
Cicala et al. (Mon,) studied this question.