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Daridorexant (Quviviq°) in insomnia

 Marketing Authorisations   The clinical evaluation of daridorexant in patients with chronic insomnia was not designed to demonstrate a potential advance compared with already available sleep-inducing drugs. While its mechanism of action is indeed different, there is no evidence that it represents a tangible clinical advance for patients.
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Patients who complain of insomnia describe an impact on daily activities due to fatigue or lack of energy. Insomnia is said to be "chronic" when the sleep disturbance has been occurring at least three times a week for 3 months or more. When cognitive behavioural therapy is not accessible or is not sufficiently effective, drugs such as benzodiazepines are an option, but their use should be limited to as short a period as possible because of their adverse effects.

Daridorexant, an antagonist of the receptors for orexins A and B, neuropeptides involved in maintenance of the waking state, has been granted marketing authorisation in Europe for adults with chronic insomnia that has an impact on daily activities. It is the first representative of this pharmacological class to be authorised in the European Union.

New is not necessarily better

It has been years since a hypnotic belonging to a new pharmacological class has been granted marketing authorisation in the European Union for the treatment of insomnia. Hopes were therefore high among certain patients and health professionals when daridorexant (Quviviq°) was authorised in Europe.

Unfortunately, after a rigorous analysis of the available evaluation data, Prescrire can only conclude that daridorexant is yet another new drug that offers "Nothing new" for patients...

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©Prescrire 1 July 2023

Source: "Daridorexant (Quviviq°) in insomnia" Prescrire International 2023; 32 (250): 173-177. Subscribers only.

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