Ann insomnia Dosing is at lower levels of Alzheimer’s disease (AD) Human pathology, results of a small proof-of-concept study.
20 milligram dose Suvorexant (Belsomra, Merck) A group of cognitively healthy individuals showed a 10% to 20% reduction in amyloid-beta (Aβ) levels and a 10% to 15% reduction in hyperphosphorylated tau over two nights.
U.S. Food and Drug Administration (FDA) Approved suvorexantis a dual orexin receptor antagonist, a Schedule IV controlled substance in 2014 and was first launched in 2015.
senior author Brendan Lucy, M.D.An associate professor of neurology and director of the Center for Sleep Medicine at Washington University in St. Louis, Missouri, he told reporters at a press conference that the study was interesting. Suvorexant It has a long history of proven safety.
“Although it is a controlled substance, its safety profile is already well known, in contrast to several other drugs being investigated as potential Alzheimer’s disease-modifying drugs and interventions.
The survey results were published online on April 20, 2023. Neurological Annals.
Lack of sleep is a risk factor for Alzheimer’s disease
The researchers noted that sleep disturbances are thought to increase the risk of Alzheimer’s disease “by increasing levels of Aβ and tau, potentially promoting the formation of amyloid plaques and the spread of tau pathology.” I’m paying attention.
Lucy has led several previous sleep cognition studies, The ‘sweet spot’ for optimal sleep prevent cognitive decline, poor sleep quality Associated with early signs of AD.
This small study enrolled 38 people aged 45 to 65 (64% female, 79% white) who were not formally screened.
Thirteen participants received 10 mg suvorexant, 12 received the 20 mg dose, and 13 received placebo. Participants took their medication at 9:00 pm each night and went to bed at the University of Washington Sleep Institute.
Researchers withdrew a small amount of cerebrospinal fluid from the lumbar catheter every 2 hours for 36 hours starting 1 hour before administration of suvorexant or placebo to measure potential changes in Aβ and tau levels.
Twenty-four hours after the first dose, hyperphosphorylated tau levels initially declined and then rose to levels similar to those in the placebo group, whereas Aβ levels remained low in the group receiving 20 mg. Levels dropped again in a similar pattern the second night when he took his second dose of 20 mg.
Good therapeutic target?
Studies in mice indicate that the orexin system, which regulates sleep/wake activity, feeding behavior, energy homeostasis, and the reward system, may be a good target in AD.
The researchers believe that suvorexant’s effects on tau and Aβ “could be through mechanisms other than sleep involving the orexin receptor signaling pathway, although further studies are needed.”
For example, there are differences between slexobant and two other FDA-approved orexin inhibitors, lemborexant (Dayvigo, Eisai) and daridrexant (Quviviq, Idorsia Pharmaceuticals), before moving to a phase 3 AD prevention trial. It is important to study whether Investigators point out.
Lucey said his group has begun large-scale trials to determine whether orexin inhibitors, given at different doses over several months, reduce Aβ and tau levels. I was. The trial will also recruit individuals with no memory or cognitive problems but evidence of biomarkers of AD pathology.
The goal is to determine if the orexin class can be used to prevent AD in its early stages.
However, Lucey warned against reading too much into this little try.
“This is really a proof-of-concept study and does not endorse going out and taking suvorexant to prevent or slow down Alzheimer’s disease.
Anne NellorePublished online on March 10, 2023. overview
This study was funded by grants from the National Institutes of Health and the Bright Focus Foundation. The authors report no relevant financial relationships.
Alicia Ault is a freelance journalist based in St. Petersburg, Florida, whose work has appeared in publications such as JAMA and Smithsonian.com. You can find her on Twitter @aliciaault.
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