Summary

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• This summary is based on the review of seven systematic review(s)/meta-analysis(es). ^[1-7]
• Solriamfetol demonstrates significant effectiveness in reducing excessive daytime sleepiness (EDS) in patients with narcolepsy, showing improvements in the Epworth Sleepiness Scale (ESS) score with a mean difference (MD) of -2.88 (95% confidence interval (CI): -4.89 to -0.88) compared to pitolisant, and an MD of -2.56 (95% CI: -4.62 to -0.51) compared to sodium oxybate. Similar improvements were observed in obstructive sleep apnea (OSA) patients, highlighting solriamfetol's efficacy across both conditions.
• In individuals with narcolepsy, solriamfetol was effective regardless of cataplexy status, while pharmacotherapy for OSA consistently improved ESS and Maintenance of Wakefulness Test (MWT) scores, indicating its relevance for various patient populations experiencing EDS.
• The safety profile of solriamfetol shows a higher incidence of adverse events, particularly in the narcolepsy population (risk ratio (RR) = 1.42, 95% CI: 1.24 to 1.64, P < 0.00001), necessitating careful consideration of individual patient factors when selecting treatment options.
• In patients with narcolepsy, solriamfetol showed a higher risk of adverse events compared to pitolisant, sodium oxybate, and modafinil, with common adverse events including headache, nausea, decreased appetite, anxiety, nasopharyngitis, and insomnia. The increased risk of adverse events was quantified with a RR of 1.42 (95% CI: 1.24 to 1.64, P < 0.00001).
• For OSA patients, pharmacotherapy with solriamfetol significantly alleviated EDS without a significant increase in serious adverse events when compared to placebo, indicating a generally favorable safety profile.
• Solriamfetol demonstrated efficacy in reducing EDS in patients with narcolepsy, effective in both those with and without cataplexy, indicating its relevance for a broad patient population. In OSA patients, pharmacotherapy, including solriamfetol, significantly alleviated EDS, supporting its use in this condition as well.