Clinical safety of daridorexant in insomnia treatment: Analysis of FDA adverse event reports

J Affect Disord. 2024 Oct 1:362:552-559. doi: 10.1016/j.jad.2024.07.034. Epub 2024 Jul 15.

Abstract

Objective: Daridorexant, a novel dual orexin receptor antagonist, was approved by the FDA in 2022 for the treatment of insomnia in adults. The aim of this study is to delve into the adverse events (AEs) of daridorexant by analyzing data from the FAERS database, to assess its safety and effectiveness in clinical applications.

Methods: This study selected data from the FAERS database from the first quarter of 2022 to the third quarter of 2023. Various data analysis methods were used, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM), to assess AEs related to daridorexant.

Results: The study analyzed a total of 2,624,030 AE reports, of which 1318 were related to daridorexant. It identified 59 preferred terms (PTs) involving 23 system organ classes (SOCs). Signal mining identified new potential AEs related to daridorexant, including sleep-related psychiatric symptoms (nightmare, abnormal dreams, sleep terror, etc.), emotional and perceptual abnormalities (hallucination, depression, agitation), physiological and behavioral responses (palpitations, dry mouth, energy increased, etc.), suicide risk (suicidal ideation, intentional overdose), and other special concern AEs (tachyphrenia, sleep-related eating disorder, hypersensitivity).

Conclusion: Although some new potential AEs have been identified, these findings need further verification in broader datasets and long-term studies due to limitations in data sources and analysis methods. Future research should comprehensively assess the safety and effectiveness of daridorexant, providing more accurate guidance for medical professionals in the treatment of insomnia.

Keywords: Adverse event; Daridorexant; FAERS database; Psychiatric symptoms; Safety.

MeSH terms

  • Adult
  • Adverse Drug Reaction Reporting Systems / statistics & numerical data
  • Aged
  • Bayes Theorem
  • Female
  • Humans
  • Imidazoles
  • Male
  • Middle Aged
  • Orexin Receptor Antagonists* / adverse effects
  • Orexin Receptor Antagonists* / therapeutic use
  • Pyrrolidines / adverse effects
  • Pyrrolidines / therapeutic use
  • Sleep Initiation and Maintenance Disorders* / chemically induced
  • Sleep Initiation and Maintenance Disorders* / drug therapy
  • United States
  • United States Food and Drug Administration*

Substances

  • Orexin Receptor Antagonists
  • daridorexant
  • Pyrrolidines
  • Imidazoles