Skip to main content
Top
Published in: Drugs 15/2014

01-10-2014 | R&D Insight Report

Suvorexant: First Global Approval

Author: Lily P. H. Yang

Published in: Drugs | Issue 15/2014

Login to get access

Abstract

Suvorexant (Belsomra®), a first-in-class, orally active dual orexin-1 receptor and orexin-2 receptor antagonist, has been developed by Merck for the treatment of insomnia. Variations in the levels of the neuropeptides orexin A and orexin B have been linked to circadian rhythms and wakefulness. Orexin-producing neurons in the lateral hypothalamus regulate wakefulness by signalling through orexin receptors. Blockade of orexin receptors is known to promote sleep. Suvorexant was approved in the US in August 2014 for the treatment of adults with sleep onset and/or sleep maintenance insomnia. The drug is also preregistration in Japan, with approval submissions planned for other countries worldwide for this indication. This article summarizes the milestones in the development of suvorexant leading to this first approval for insomnia.
Literature
2.
go back to reference Mieda M, Sakurai T. Orexin (hypocretin) receptor agonists and antagonists for treatment of sleep disorders: rationale for development and current status. CNS Drugs. 2013;27(2):83–90.PubMedCrossRef Mieda M, Sakurai T. Orexin (hypocretin) receptor agonists and antagonists for treatment of sleep disorders: rationale for development and current status. CNS Drugs. 2013;27(2):83–90.PubMedCrossRef
5.
go back to reference Merck & Co. Merck receives Complete Response Letter for suvorexant, Merck’s investigational medicine for insomnia [media release]. 1 July 2013. http://www.merck.com. Merck & Co. Merck receives Complete Response Letter for suvorexant, Merck’s investigational medicine for insomnia [media release]. 1 July 2013. http://​www.​merck.​com.
7.
go back to reference Connor K, Budd K, Snavely D, et al. Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: a 3-month phase 3 trial (trial #1) [abstract no. O324]. J Sleep Res. 2012;21(Suppl 1):97. Connor K, Budd K, Snavely D, et al. Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: a 3-month phase 3 trial (trial #1) [abstract no. O324]. J Sleep Res. 2012;21(Suppl 1):97.
8.
go back to reference Ivgy-May N, Leibensperger H, Froman S, et al. Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: a 3-month phase 3 trial (trial #2) [abstract no. P988]. J Sleep Res. 2012;21(Suppl 1):351–2. Ivgy-May N, Leibensperger H, Froman S, et al. Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: a 3-month phase 3 trial (trial #2) [abstract no. P988]. J Sleep Res. 2012;21(Suppl 1):351–2.
9.
go back to reference Michelson D, Snyder E, Paradis E, et al. Safety and efficacy of suvorexant during 1-year treatment of insomnia with subsequent abrupt treatment discontinuation: a phase 3 randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2014;13(5):461–71.PubMedCrossRef Michelson D, Snyder E, Paradis E, et al. Safety and efficacy of suvorexant during 1-year treatment of insomnia with subsequent abrupt treatment discontinuation: a phase 3 randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2014;13(5):461–71.PubMedCrossRef
10.
go back to reference Herring WJ, Snyder E, Budd K, et al. Orexin receptor antagonism for treatment of insomnia: a randomized clinical trial of suvorexant. Neurology. 2012;79(23):2265–74.PubMedCrossRef Herring WJ, Snyder E, Budd K, et al. Orexin receptor antagonism for treatment of insomnia: a randomized clinical trial of suvorexant. Neurology. 2012;79(23):2265–74.PubMedCrossRef
11.
go back to reference Merck & Co. Merck announces full-year and fourth-quarter 2012 financial results. 2012. Merck & Co. Merck announces full-year and fourth-quarter 2012 financial results. 2012.
12.
go back to reference Winrow CJ, Gotter AL, Cox CD, et al. Promotion of sleep by suvorexant: a novel dual orexin receptor antagonist. J Neurogenet. 2011;25(1–2):52–61.PubMedCrossRef Winrow CJ, Gotter AL, Cox CD, et al. Promotion of sleep by suvorexant: a novel dual orexin receptor antagonist. J Neurogenet. 2011;25(1–2):52–61.PubMedCrossRef
14.
go back to reference Sun H, Kennedy D, Lewis N, et al. The single dose pharmacokinetic (PK) and pharmacodynamic (PD) profiles of suvorexant (MK-4305), a dual orexin receptor antagonist, in healthy male subjects [abstract no. PI-59]. Clin Pharmacol Ther. 2012;91(Suppl 1):S29. Sun H, Kennedy D, Lewis N, et al. The single dose pharmacokinetic (PK) and pharmacodynamic (PD) profiles of suvorexant (MK-4305), a dual orexin receptor antagonist, in healthy male subjects [abstract no. PI-59]. Clin Pharmacol Ther. 2012;91(Suppl 1):S29.
15.
go back to reference Sun H, Kennedy WP, Wilbraham D, et al. Effects of suvorexant, an orexin receptor antagonist, on sleep parameters as measured by polysomnography in healthy men. Sleep. 2013;36(2):259–67.PubMedPubMedCentral Sun H, Kennedy WP, Wilbraham D, et al. Effects of suvorexant, an orexin receptor antagonist, on sleep parameters as measured by polysomnography in healthy men. Sleep. 2013;36(2):259–67.PubMedPubMedCentral
16.
go back to reference Sun H, Yee KL, Khalilieh S, et al. Phase 1 safety, pharmacokinetics, and pharmacodynamics of the orexin receptor antagonist suvorexant administered with alcohol or paroxetine [abstract no. 0650]. Sleep. 2013;36(Suppl):A224. Sun H, Yee KL, Khalilieh S, et al. Phase 1 safety, pharmacokinetics, and pharmacodynamics of the orexin receptor antagonist suvorexant administered with alcohol or paroxetine [abstract no. 0650]. Sleep. 2013;36(Suppl):A224.
17.
go back to reference Herring WJ, Ivgy-May N, Connor KM, et al. Effect of suvorexant, an orexin receptor antagonist, on patient-reported outcomes in patients with primary insomnia: integrated results from two phase-3 trials [abstract no. 0648]. Sleep. 2013;36(Suppl):A223. Herring WJ, Ivgy-May N, Connor KM, et al. Effect of suvorexant, an orexin receptor antagonist, on patient-reported outcomes in patients with primary insomnia: integrated results from two phase-3 trials [abstract no. 0648]. Sleep. 2013;36(Suppl):A223.
18.
go back to reference Hisada S, Kikuchi M, Takahashi K, et al. Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: a 3-month phase III study (P028) [abstract no. 0649]. Sleep. 2013;36(Suppl):A224. Hisada S, Kikuchi M, Takahashi K, et al. Efficacy and safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: a 3-month phase III study (P028) [abstract no. 0649]. Sleep. 2013;36(Suppl):A224.
19.
go back to reference Connor KM, Matzura-Wolfe D, Zhang Y, et al. Safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: integrated phase 3 results [abstract no. 0647]. Sleep. 2013;36(Suppl):A223. Connor KM, Matzura-Wolfe D, Zhang Y, et al. Safety of suvorexant, an orexin receptor antagonist, in patients with primary insomnia: integrated phase 3 results [abstract no. 0647]. Sleep. 2013;36(Suppl):A223.
20.
go back to reference Vermeeren A, Vuurman E, Van Oers A, et al. Effects of suvorexant, an orexin receptor antagonist, on next day driving performance in healthy volunteers [abstract no. W11]. In: 51st Annual Meeting of the American College of Neuropsychopharmacology; 2–6 Dec 2012; Hollywood (FL). Vermeeren A, Vuurman E, Van Oers A, et al. Effects of suvorexant, an orexin receptor antagonist, on next day driving performance in healthy volunteers [abstract no. W11]. In: 51st Annual Meeting of the American College of Neuropsychopharmacology; 2–6 Dec 2012; Hollywood (FL).
21.
go back to reference Uemura N, McCrea J, Sun H, et al. Effects of supratherapeutic and therapeutic doses of the orexin receptor antagonist suvorexant on respiration during sleep in healthy subjects [abstract no. 0645]. Sleep. 2013;36(Suppl):A222. Uemura N, McCrea J, Sun H, et al. Effects of supratherapeutic and therapeutic doses of the orexin receptor antagonist suvorexant on respiration during sleep in healthy subjects [abstract no. 0645]. Sleep. 2013;36(Suppl):A222.
22.
go back to reference Troyer M, Uemura N, McCrea J, et al. Respiratory safety of the orexin receptor antagonist suvorexant during sleep in patients with compromised respiratory function and in healthy subjects [abstract no. P5.293]. Neurology. 2014;82(10 Suppl 1). Troyer M, Uemura N, McCrea J, et al. Respiratory safety of the orexin receptor antagonist suvorexant during sleep in patients with compromised respiratory function and in healthy subjects [abstract no. P5.293]. Neurology. 2014;82(10 Suppl 1).
Metadata
Title
Suvorexant: First Global Approval
Author
Lily P. H. Yang
Publication date
01-10-2014
Publisher
Springer International Publishing
Published in
Drugs / Issue 15/2014
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-014-0294-5

Other articles of this Issue 15/2014

Drugs 15/2014 Go to the issue