Promising Results for Oveporexton in Enhancing Wakefulness in Narcolepsy Type 1

Recent research conducted by Gui de Chauliac Hospital in Montpellier, France, in collaboration with the University of Bologna in Italy, has demonstrated that oveporexton may offer a new therapeutic avenue for individuals with narcolepsy type 1. This disorder, characterized by excessive daytime sleepiness and sudden muscle weakness episodes known as cataplexy, results from a deficiency of orexin, a neuropeptide vital for maintaining wakefulness and regulating REM sleep transitions.

Current treatments primarily aim to manage symptoms without addressing the root cause — the orexin deficiency. Previously, efforts to target orexin receptor 2 (OX2R) have shown promise in improving wakefulness and reducing cataplexy but were limited by hepatotoxic side effects, restricting their clinical use.

The study titled "Oveporexton, an Oral Orexin Receptor 2–Selective Agonist, in Narcolepsy Type 1," published in The New England Journal of Medicine, evaluated the safety and effectiveness of oveporexton in a Phase II trial. This randomized, double-blind, placebo-controlled study involved 112 adults across multiple international sites, who received either various dosages of oveporexton or placebo over eight weeks.

Assessment of wakefulness through the Maintenance of Wakefulness Test (MWT), along with evaluations of daytime sleepiness via the Epworth Sleepiness Scale (ESS) and recording of cataplexy episodes, revealed significant improvements among patients treated with oveporexton. The treatment increased sleep latency on the MWT by up to 25.4 minutes and reduced ESS scores considerably compared to placebo. Notably, the frequency of cataplexy episodes decreased, with the most effective dosages showing a reduction to nearly half the baseline episodes.

While some adverse effects like insomnia, urinary urgency, and increased urination were reported, none led to discontinuation of treatment. Importantly, oveporexton did not cause liver-related side effects, setting it apart from other OX2R-targeting drugs.

These promising findings suggest that oveporexton could become a safer, effective option for managing narcolepsy type 1, significantly enhancing wakefulness and reducing symptoms. Further studies, including large-scale Phase III trials, are underway to solidify its long-term safety and efficacy.

source: https://medicalxpress.com/news/2025-05-oveporexton-narcolepsy.html