Citation

Wang YG, Swick TJ, Carter LP, Thorpy MJ, Benowitz NL. J. Clin. Sleep Med. 2009; 5(4): 365-371.

Affiliation

Jazz Pharmaceuticals, Inc. Palo Alto, CA 94304, USA. Grace.Wang@jazzpharma.com

Copyright

(Copyright © 2009, American Academy of Sleep Medicine)

DOI

unavailable

PMID

19968016

PMCID

PMC2725257

Abstract

STUDY OBJECTIVES: This study reviewed the cumulative postmarketing and clinical safety experience with sodium oxybate (Xyrem), a treatment approved for cataplexy and excessive daytime sleepiness in narcolepsy. Study objectives were to investigate the occurrence of abuse/misuse of sodium oxybate since first market introduction in 2002, classify cases using DSM-IV criteria for substance abuse and dependence, and describe specific characteristics of these cases. METHODS: We retrospectively reviewed postmarketing spontaneous adverse event (AE) reports from 15 countries for all cases containing reporting terminology related to abuse/misuse to determine its occurrence. All death cases independent of causality were reviewed to identify associated risk factors. RESULTS: Approximately 26,000 patients worldwide received sodium oxybate from first market introduction in 2002 through March 2008. Of those 26,000 patients, 0.2% reported > or = 1 of the events studied. These included 10 cases (0.039%) meeting DSM-IV abuse criteria, 4 cases (0.016%) meeting DSM-IV dependence criteria, 8 cases (0.031%, including 3 of the previous 4) with withdrawal symptoms reported after discontinuation of sodium oxybate, 2 confirmed cases (0.008%) of sodium oxybate-facilitated sexual assault, 8 cases (0.031%) of overdose with suicidal intent, 21 deaths (0.08%) in patients receiving sodium oxybate treatment with 1 death known to be related to sodium oxybate, and 3 cases (0.01%) of traffic accidents involving drivers taking sodium oxybate. During this period, approximately 600,000 bottles of sodium oxybate were distributed, and 5 incidents (0.0009%) of diversion were reported. CONCLUSION: Cumulative postmarketing and clinical experience indicates a very low risk of abuse/misuse of sodium oxybate.

Language: en