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Boss C, Gatfield J, Brotschi C, Heidmann B, Sifferlen T, von Raumer M, Schmidt G, Williams JT, Treiber A, Roch C. The Quest for the Best Dual Orexin Receptor Antagonist (Daridorexant) for the Treatment of Insomnia Disorders. ChemMedChem 2020; 15:2286-2305. [PMID: 32937014 DOI: 10.1002/cmdc.202000453] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/06/2020] [Indexed: 02/06/2023]
Abstract
Since its discovery in 1998, the orexin system has been of interest to the research community as a potential therapeutic target for the treatment of sleep/wake disorders, stress and anxiety disorders, addiction or eating disorders. It consists of two G protein-coupled receptors, the orexin 1 and orexin 2 receptors, and two neuropeptides with agonistic effects, the orexin A and orexin B peptides. Herein we describe our efforts leading to the identification of a promising set of dual orexin receptor antagonists (DORAs) which subsequently went through physiology-based pharmacokinetic and pharmacodynamic modelling>[1] and finally led to the selection of daridorexant, currently in phase 3 clinical trials for the treatment of insomnia disorders.
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Affiliation(s)
- Christoph Boss
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - John Gatfield
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Christine Brotschi
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Bibia Heidmann
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Thierry Sifferlen
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Markus von Raumer
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Gunther Schmidt
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Jodi T Williams
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Alexander Treiber
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
| | - Catherine Roch
- Drug Discovery and Preclinical Research & Development, Idorsia Pharmaceuticals Ltd., Hegenheimermattweg 91, 4123, Allschwil, BL, Switzerland
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Barateau L, Dauvilliers Y. Recent advances in treatment for narcolepsy. Ther Adv Neurol Disord 2019; 12:1756286419875622. [PMID: 31632459 PMCID: PMC6767718 DOI: 10.1177/1756286419875622] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/21/2019] [Indexed: 11/17/2022] Open
Abstract
Narcolepsy type 1 (NT1) is a chronic orphan disorder, caused by the selective and irreversible loss of hypocretin/orexin (ORX) neurons, by a probable autoimmune process. Little is known about NT2 etiology and prevalence, sharing with NT1 excessive daytime sleepiness (EDS) and dysregulation of rapid eye movement (REM) sleep, but without cataplexy and loss of ORX neurons. Despite major advances in our understanding of the neurobiological basis of NT1, management remains nowadays only symptomatic. The main and most disabling symptom, EDS, is managed with psychostimulants, as modafinil/armodafinil, methylphenidate, or amphetamines as a third-line therapy. Narcolepsy is an active area for drug development, and new wake-promoting agents have been developed over the past years. Pitolisant, a selective histamine H3 receptor inverse agonist, has been recently approved to treat patients with NT1 and NT2. Solriamfetol, a phenylalanine derivative with dopaminergic and noradrenergic activity will be soon a new therapeutic option to treat EDS in NT1 and NT2. Sodium oxybate, used for decades in adult patients with narcolepsy, was recently shown to be effective and safe in childhood narcolepsy. The discovery of ORX deficiency in NT1 opened new therapeutic options oriented towards ORX-based therapies, especially nonpeptide ORX receptor agonists that are currently under development. In addition, immune-based therapies administered as early as possible after disease onset could theoretically slow down or stop the destruction of ORX neurons in some selected patients. Further well-designed controlled trials are required to determine if they could really impact on the natural history of the disease. Given the different clinical, biological and genetic profiles, narcolepsy may provide a nice example for developing personalized medicine in orphan diseases, that could ultimately aid in similar research and clinical efforts for other conditions.
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Affiliation(s)
- Lucie Barateau
- Service de Neurologie, Gui-de-Chauliac Hospital,
Montpellier, France; Sleep-Wake Disorders Center, Gui-de-Chauliac Hospital,
CHU Montpellier, France; National Reference Network for Narcolepsy,
Montpellier, France; Inserm U1061, Montpellier, France
| | - Yves Dauvilliers
- Service de Neurologie, Gui-de-Chauliac Hospital,
CHU Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5,
France
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Takahashi T, Noriaki S, Matsumura M, Li C, Takahashi K, Nishino S. Advances in pharmaceutical treatment options for narcolepsy. Expert Opin Orphan Drugs 2018. [DOI: 10.1080/21678707.2018.1521267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Tatsunori Takahashi
- Stanford University Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Sakai Noriaki
- Stanford University Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Mari Matsumura
- Stanford University Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Chenyu Li
- Stanford University Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kayo Takahashi
- Stanford University Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Seiji Nishino
- Stanford University Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
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