wHAT HAVE ACTUAL PATIENTS EXPERIENCED IN TREATMENT wITH XYREM?

HOw HAVE ACTUAL PATIENTS EXPERIENCED TREATMENT wITH XYREM?

Meet Susan.

Diagnosed with narcolepsy type 2 (narcolepsy without cataplexy).

59 years old | Speech therapist
Effective XYREM dosage: 6 g per night

Patient stories are based on actual patient experiences. Response to XYREM may be different for each individual.

Presentation

  • Referred to sleep specialist for chronic sleepiness, including unintended lapses into sleep at work and at home.
  • Clinical interview reveals long history of excessive daytime sleepiness (EDS):
    • Symptoms began in college, manifesting as an inability to remain awake during class and while studying.
    • Continued EDS causing concern about dozing/falling asleep in everyday situations.
  • History also included OSA and regular CPAP use.
  • Insufficient sleep appears unlikely (patient reports adequate hours of sleep at night).
  • No evidence, by interview, of sleep disorders other than OSA (eg, restless legs syndrome, periodic limb movements in sleep, or circadian rhythm sleep-wake disorders).
  • Epworth Sleepiness Scale (ESS) score = 17.
Learn about Susan’s diagnosis >

OSA = obstructive sleep apnea; CPAP = continuous positive airway pressure therapy.

Diagnosis

  • On initial overnight PSG:
    • Diagnosed with mild OSA.
    • Sleep-onset latency of 3 minutes observed.
    • Latency to REM sleep was 50 minutes after sleep onset.
    • No evidence of other primary sleep disorder (eg, no significant periodic limb movements in sleep).
  • On a repeat PSG (with CPAP):
    • OSA ruled out as cause of persistent EDS.
    • Latency to REM sleep was 45 minutes after sleep onset.
  • On the MSLT:
    • Mean sleep latency was 3.3 minutes.
    • SOREMPs observed on 3 out of 4 nap trials.
  • Diagnosis of narcolepsy type 2 established:
    • No apparent history of cataplexy on clinical interview.
Learn about Susan’s treatment >

MSLT = multiple sleep latency test; OSA = obstructive sleep apnea; CPAP = continuous positive airway pressure therapy; PSG = polysomnogram; SOREMP = sleep onset REM period (within 15 min of sleep onset).

Treatment

  • Counseled regarding XYREM therapy.
  • Enrolled in the XYREM® REMS Program.
  • Initial dosage:
    • 4.5 g per night in 2 equal, divided doses (2.25 g at bedtime, 2.25 g 2.5–4 hours later).
  • Titrated to effective dosage:
    • By increasing total nightly dosage by 1.5 g per night (added 0.75 g at bedtime and 0.75 g 2.5–4 hours later) at weekly intervals.
  • Effective dosage:
    • 6.0 g per night in 2 equal, divided doses (3 g at bedtime and 3 g 2.5–4 hours later) produced significant reductions in EDS; therapy well tolerated.
    • 7.5 g per night in 2 equal, divided doses (3.75 g at bedtime and 3.75 g 2.5–4 hours later) continued reductions in EDS; nausea and mild ankle edema reported.
    • Reducing dosage to 6.0 g per night maintained significant reductions in EDS; nausea and edema improved. Adverse events reported to Jazz Pharmaceuticals.
STARTING & TITRATING XYREM

Find out about how to start patients on XYREM.

STARTING & TITRATING XYREM
SETTING A ROUTINE

Find out about counseling patients on how to take XYREM.

SETTING A ROUTINE