The annual meeting of the American College of Chest Physicians was held this year from Oct. 6 to 9 in Boston, hosting participants from around the world, including specialists and heath care professionals focused on pulmonary medicine, critical care, and sleep medicine. The conference featured presentations focusing on clinical updates in thoracic medicine.
In one study, Chitra Lal, M.D., of the Medical University of South Carolina in Charleston, and colleagues found that the efficacy and safety of low sodium oxybate (LXB) in participants with idiopathic hypersomnia are similar in the presence or absence of asthma and mild and controlled sleep apnea.
The authors titrated and optimized the dose of LXB (10 to 14 weeks) among participants with idiopathic hypersomnia and an apnea-hypopnea index ≤10 before a two-week stable-dose period. During a two-week double-blind randomized withdrawal period (DBRWP), participants were switched to placebo or continued with LXB.
Across subgroups with and without asthma or sleep apnea, the researchers found that participants who were randomly assigned to placebo showed worsening in their Idiopathic Hypersomnia Severity Scale, Epworth Sleepiness Scale, and Sleep Inertia Visual Analog Scale scores at the end of the DBRWP, while participants randomly assigned to continue LXB showed stable scores. In addition, significantly higher proportions of participants who were assigned to placebo reported worsening Patient Global Impression of Change score status (minimally, much, or very much worse) at the end of the DBRWP compared with participants receiving LXB, regardless of the presence or absence of asthma or sleep apnea. Incidences of treatment-emergent adverse events, including those that were serious, those related to the study drug, and those leading to withdrawal, were similar among participants with asthma or sleep apnea and among participants without these comorbidities.
“Overall, these findings inform clinicians about the efficacy and safety of LXB in this patient population with asthma and mild and controlled sleep apnea. This would increase the comfort level of clinicians in prescribing LXB for idiopathic hypersomnia in this specific patient population,” Lal said. “However, the small sample size and the inclusion of patients with mild and controlled sleep apnea only (exclusion of individuals with an apnea-hypopnea index >10 in the main study) would restrict extrapolation of these findings to the wider idiopathic hypersomnia population.”
Several authors disclosed ties to pharmaceutical companies, including Jazz Pharmaceuticals, which manufactures LXB (Xywav) and funded the study.