Kota Hatano

We conducted a retrospective study using medical records from Fujita Health University Hospital to evaluate the treatment discontinuation rates of suvorexant and lemborexant in patients with insomnia and to clarify differences in treatment acceptability. This study included patients newly prescribed suvorexant or lemborexant in the Department of Psychiatry between July 2020 and December 2022. The primary endpoint of the study was the discontinuation rate of suvorexant and lemborexant at 4 weeks. Discontinuation due to adverse events and lack of efficacy were assessed as secondary outcomes. The medical records of 1404 patients who were initiated on a dual orexin receptor antagonist during the study period were reviewed, and 1091 patients were included in the final analysis (suvorexant, 323; lemborexant, 768). We estimated the average treatment effect using the inverse probability of treatment weighting based on the propensity score. Discontinuation rates due to all-cause or adverse events did not differ significantly between the two drugs. However, the discontinuation rate due to lack of efficacy was significantly lower for lemborexant (4.9%; 38/768) compared to suvorexant (7.1%; 23/323), with an odds ratio of 0.63 (95% confidence interval, 0.48-0.83). This exploratory finding suggests a potential difference in treatment acceptability associated with efficacy between suvorexant and lemborexant in routine clinical practice, warranting further investigation.