Prevalence of Hypertension Over (Calendar) Time Among People With Narcolepsy Treated With Oxybate
Author(s)
Sarah C. Markt, ScD, MPH1, Jennifer Polinski, ScD, MPH, MSc2, Marisa Whalen, PharmD3, John Kroner, MS2, Elizabeth M. Poole, PhD1, John Shen, MSPH2, Jessica K. Alexander, PhD1, Virend K. Somers, MD, PhD4;
1Jazz Pharmaceuticals, Palo Alto, CA, USA, 2Aetion, Inc., New York, NY, USA, 3Jazz Pharmaceuticals, Philadelphia, PA, USA, 4Mayo Clinic, Cardiovascular Medicine, Rochester, MN, USA
1Jazz Pharmaceuticals, Palo Alto, CA, USA, 2Aetion, Inc., New York, NY, USA, 3Jazz Pharmaceuticals, Philadelphia, PA, USA, 4Mayo Clinic, Cardiovascular Medicine, Rochester, MN, USA
Presentation Documents
OBJECTIVES: Narcolepsy is associated with cardiovascular, cardiometabolic, and renal comorbidities. Higher sodium intake is also associated with greater risk of these conditions, especially hypertension (HTN). Sodium oxybate (SXB), used to treat narcolepsy, contains ~1100-1600 mg of sodium per daily standard dosage. A low-sodium oxybate (LXB) alternative became available in November 2020. We evaluated the prevalence of HTN over time among individuals with narcolepsy and whether approval of LXB impacted HTN prevalence at initiation of SXB among new SXB initiators and at time of SXB-to-LXB switch.
METHODS: A retrospective, cross-sectional study using the Optum® Market Clarity dataset (2019-2023) examined individuals with narcolepsy, aged 18-84 years, with >6 months insurance enrollment. Monthly HTN prevalence was calculated, age-standardized to the 2020 US Census, and stratified by age and sex among (1) individuals with narcolepsy overall (treatment agnostic) and by treatment; (2) new SXB initiators; (3) new LXB initiators; (4) SXB-to-LXB switchers; and (5) new and existing SXB users. Interrupted time series analysis assessed changes in HTN prevalence in these groups pre- and post-market introduction of LXB.
RESULTS: Mean age at treatment initiation was 38 years in new SXB users (n=984) and 41 years in new LXB users (n=776). As LXB initiation increased, SXB use decreased. Overall and age-adjusted HTN prevalence estimates month-over-month were similar at time of new initiation of SXB and LXB and at switch. HTN prevalence among new and existing SXB users was 51% and increased slightly over time. Among new SXB initiators, HTN prevalence estimates did not change following LXB availability (−0.3% points [95% CI: −1.8, 1.2]).
CONCLUSIONS: HTN prevalence was high among new SXB initiators prior to LXB approval, and prevalence remained steady despite availability of a low-sodium option. These findings emphasize the need for additional consideration of sodium risks due to the well-established relationship between sodium intake and HTN.
METHODS: A retrospective, cross-sectional study using the Optum® Market Clarity dataset (2019-2023) examined individuals with narcolepsy, aged 18-84 years, with >6 months insurance enrollment. Monthly HTN prevalence was calculated, age-standardized to the 2020 US Census, and stratified by age and sex among (1) individuals with narcolepsy overall (treatment agnostic) and by treatment; (2) new SXB initiators; (3) new LXB initiators; (4) SXB-to-LXB switchers; and (5) new and existing SXB users. Interrupted time series analysis assessed changes in HTN prevalence in these groups pre- and post-market introduction of LXB.
RESULTS: Mean age at treatment initiation was 38 years in new SXB users (n=984) and 41 years in new LXB users (n=776). As LXB initiation increased, SXB use decreased. Overall and age-adjusted HTN prevalence estimates month-over-month were similar at time of new initiation of SXB and LXB and at switch. HTN prevalence among new and existing SXB users was 51% and increased slightly over time. Among new SXB initiators, HTN prevalence estimates did not change following LXB availability (−0.3% points [95% CI: −1.8, 1.2]).
CONCLUSIONS: HTN prevalence was high among new SXB initiators prior to LXB approval, and prevalence remained steady despite availability of a low-sodium option. These findings emphasize the need for additional consideration of sodium risks due to the well-established relationship between sodium intake and HTN.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH31
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Neurological Disorders