Pharmacological Interventions for Excessive Daytime Sleepiness in Adults with Narcolepsy: A Systematic Review and Network Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Eligibility Criteria
2.3. Study Quality and Risk of Bias
2.4. Outcomes and Data Extraction
2.5. Statistical Analysis
3. Results
3.1. Study Selection and Baseline Characteristics
3.2. Primary Outcomes
3.2.1. Change in Epworth Sleepiness Scale
3.2.2. Change in Maintenance of Wakefulness Test
3.3. Secondary Outcomes
3.3.1. Change in Cataplexy Rate
3.3.2. Clinical Global Impression of Change
3.3.3. Adverse Events
3.4. Three-Dimensional Clustered Ranking Plot
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Change in ESS | ||||||
---|---|---|---|---|---|---|
Solriamfetol | ||||||
−1.39 (−3.10–0.31) | Modafinil | |||||
−1.76 (−4.27–0.74) | −0.37 (−2.73–1.99) | Lower-sodium oxybate | ||||
−2.56 (−4.62–−0.51) | −1.17 (−3.04–0.70) | −0.80 (−3.42–1.82) | Sodium oxybate | |||
−2.88 (−4.89–−0.88) | −1.49 (−3.07–0.09) | −1.12 (−3.70–1.46) | −0.32 (−2.46–1.82) | Pitolisant | ||
−4.76 (−6.11–−3.42) | −3.37 (−4.42–−2.33) | −3.00 (−5.11–−0.89) | −2.20 (−3.75–−0.65) | −1.88 (−3.36–−0.40) | Placebo | |
Change in MWT | ||||||
Solriamfetol | ||||||
0.39 (−0.17–0.94) | Armodafinil | |||||
0.42 (0.05–0.79) | 0.03 (−0.48–0.54) | Modafinil | ||||
0.42 (−0.02–0.87) | 0.03 (−0.53–0.59) | 0.00 (−0.35–0.35) | Sodium oxybate | |||
0.45 (0.02–0.88) | 0.06 (−0.49–0.62) | 0.03 (−0.32–0.38) | 0.03 (−0.41–0.47) | Pitolisant | ||
0.97 (0.67–1.28) | 0.58 (0.12–1.05) | 0.55 (0.34–0.77) | 0.55 (0.23–0.87) | 0.52 (0.22–0.83) | Placebo | |
Change in cataplexy rate | ||||||
Pitolisant | ||||||
−0.09 (−0.84–0.67) | Lower-sodium oxybate | |||||
−0.32 (−0.86–0.21) | −0.24 (−0.97–0.49) | Sodium oxybate | ||||
−0.53 (−1.19–0.13) | −0.44 (−1.35–0.48) | −0.20 (−0.95–0.55) | Modafinil | |||
−0.72 (−1.46–0.01) | −0.64 (−1.52–0.25) | −0.40 (−1.11–0.31) | −0.20 (−1.10–0.71) | Armodafinil | ||
−0.72 (−1.13–−0.32) | −0.64 (−1.27–0.00) | −0.40 (−0.76–−0.04) | −0.20 (−0.86–0.46) | −0.00 (−0.62–0.62) | Placebo | |
CGI-C | ||||||
Lower-sodium oxybate | ||||||
1.76 (0.80–3.85) | Armodafinil | |||||
1.83 (0.94–3.55) | 1.04 (0.57–1.90) | Sodium oxybate | ||||
1.90 (0.98–3.66) | 1.08 (0.59–1.96) | 1.04 (0.68–1.59) | Solriamfetol | |||
2.27 (1.14–4.52) | 1.29 (0.68–2.42) | 1.24 (0.78–1.98) | 1.19 (0.75–1.91) | Pitolisant | ||
2.42 (1.28–4.57) | 1.37 (0.78–2.43) | 1.32 (0.91–1.91) | 1.27 (0.87–1.87) | 1.07 (0.74–1.54) | Modafinil | |
3.82 (2.12–6.88) | 2.17 (1.30–3.64) | 2.09 (1.53–2.84) | 2.02 (1.50–2.71) | 1.69 (1.17–2.43) | 1.58 (1.24–2.02) | Placebo |
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Chien, P.-Y.; Kuo, C.-Y.; Lin, M.-H.; Chang, Y.-J.; Hung, C.-C. Pharmacological Interventions for Excessive Daytime Sleepiness in Adults with Narcolepsy: A Systematic Review and Network Meta-Analysis. J. Clin. Med. 2022, 11, 6302. https://doi.org/10.3390/jcm11216302
Chien P-Y, Kuo C-Y, Lin M-H, Chang Y-J, Hung C-C. Pharmacological Interventions for Excessive Daytime Sleepiness in Adults with Narcolepsy: A Systematic Review and Network Meta-Analysis. Journal of Clinical Medicine. 2022; 11(21):6302. https://doi.org/10.3390/jcm11216302
Chicago/Turabian StyleChien, Po-Yu, Chan-Yen Kuo, Meng-Hsuan Lin, Yao-Jen Chang, and Chin-Chuan Hung. 2022. "Pharmacological Interventions for Excessive Daytime Sleepiness in Adults with Narcolepsy: A Systematic Review and Network Meta-Analysis" Journal of Clinical Medicine 11, no. 21: 6302. https://doi.org/10.3390/jcm11216302
APA StyleChien, P. -Y., Kuo, C. -Y., Lin, M. -H., Chang, Y. -J., & Hung, C. -C. (2022). Pharmacological Interventions for Excessive Daytime Sleepiness in Adults with Narcolepsy: A Systematic Review and Network Meta-Analysis. Journal of Clinical Medicine, 11(21), 6302. https://doi.org/10.3390/jcm11216302