Takeda has shared detailed data from two Phase 3 trials of its orexin agonist in narcolepsy type 1, bringing the Japanese drugmaker a step closer to a market that Wall Street says could generate sales of over $9 billion.
In July, Takeda announced that its oral treatment oveporexton
met all endpoints
in the FirstLight and RadiantLight studies. This included the primary endpoint of change in the Maintenance of Wakefulness Test (MWT) at 12 weeks. On Monday, the company offered a closer look at those Phase 3 results at the World Sleep Congress in Singapore.
The MWT measures how long patients stay awake when put in a dark, quiet room at regular intervals over eight hours. While a healthy person can generally stay awake for at least 20 minutes in similar conditions, people with narcolepsy typically fall asleep within six minutes at most.
In the FirstLight study, narcolepsy type 1 (NT1) patients given 1 mg of oveporexton stayed awake for an average 19.3 minutes, and those given the 2 mg dose stayed awake for 21.8 minutes. That compared with 4.5 minutes for placebo.
And in the RadiantLight study, patients given 2 mg of oveporexton stayed awake for an average of 24.6 minutes, versus 3.3 minutes for placebo.
On the current standard of care, patients often need to take more than one medicine multiple times a day or at night, Takeda’s head of neuroscience Sarah Sheikh told
Endpoints News
in an interview. But existing treatments, which include stimulants and the drug sodium oxybate, don’t address the underlying cause of the disease, which is a deficiency in a neurotransmitter called orexin, Sheikh said.
Orexin agonists like oveporexton, Alkermes’ alixorexton and Centessa Pharmaceuticals’ ORX750 mimic a neuropeptide called orexin that regulates wakefulness.
Last week, Jefferies analysts estimated that these three drugs alone could reach $6.7 billion in sales in 2034. They added that the total potential market for orexin agonists could be worth more than $9 billion.
Sheikh said Takeda plans to file for approval of oveporexton this fiscal year. The company is also advancing another orexin agonist, called TAK-360, for narcolepsy type 2 and idiopathic hypersomnia.
Takeda may have competition, however.
Alkermes also presented Phase 2 data for alixorexton in NT1 at the medical meeting on Monday. The drug seemed to do better on the wakefulness test, with its highest 8 mg dose keeping patients awake for around 28 minutes. That’s about three and a half minutes longer than the 2 mg oveporexton dose in Takeda’s RadiantLight study. Alixorexton is also designed for once-daily dosing, compared with Takeda’s twice-a-day pill.
However, only the middle of the three alixorexton doses (6 mg) achieved statistical significance in improving rates of cataplexy, or involuntary muscle weakness, versus placebo. Cataplexy is one of the defining symptoms of NT1.
Oveporexton slashed the weekly cataplexy rate by more than 80% at 12 weeks in Takeda’s Phase 3 program. The average number of cataplexy-free days versus placebo also improved from zero at baseline to four to five days within that time.