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Abstract Details

Increased Risk of Hypertension Onset Among Patients With Narcolepsy Newly Treated With High-Sodium Oxybate
Sleep
P5 - Poster Session 5 (11:45 AM-12:45 PM)
11-002
This study compared intermediate-term risk (≤180 days) of new-onset hypertension among normotensive patients with narcolepsy initiating high-sodium oxybate (SXB cohort) with those not initiating high-sodium oxybate (controls). 
High-sodium oxybate, a recommended narcolepsy treatment, contains a high-sodium content warning in its US Food and Drug Administration–approved labeling. The sodium-hypertension relationship is well established. 
MarketScan® claims (1/2014 to 2/2020) were analyzed. Eligible adults had continuous enrollment and ≥1 narcolepsy claim or prescription for sodium oxybate. Patients with a history of hypertension, use of antihypertensives, and prior use of sodium oxybate were excluded. In a sensitivity analysis, patients with a history of cardiovascular disease (CVD) were also excluded. Two endpoints were assessed: 1) a composite of new-onset hypertension diagnosis or initiation of antihypertensive medication and 2) new-onset hypertension diagnosis alone. Propensity-score 1:2 matching was applied to balance baseline characteristics. Risk per 100 patients and adjusted odds ratios (ORs) were reported with 95% confidence intervals (CIs). 

A total of 954 and 1906 patients were included in the SXB and control cohorts, respectively. Risk of the composite endpoint per 100 patients was higher in SXB (6.60) than control (4.20) cohorts (OR=1.61; 95% CI, 1.15–2.27); risk of new-onset hypertension per 100 patients was higher in SXB (0.94) than control (0.52) cohorts (OR=1.81; 95% CI, 0.73–4.46). In the sensitivity analysis, risk of the composite endpoint per 100 patients was higher in SXB (6.22) than control (4.06) cohorts (OR=1.57; 95% CI, 1.10–2.24); risk of new-onset hypertension per 100 patients was higher in SXB (0.89) than control (0.44) cohorts (OR=2.01; 95% CI, 0.75–5.36).
This study showed increased risk of new-onset hypertension among normotensive patients with narcolepsy treated with sodium oxybate, even among patients without history of CVD. Clinicians should consider the cardiovascular risk associated with high-sodium oxybate. 
Authors/Disclosures
Wayne Macfadden, MD, PT
PRESENTER 		Dr. Macfadden has received personal compensation for serving as an employee of Jazz pharma. Dr. Macfadden has stock in Jazz pharma.
Rami Ben-Joseph, PhD Dr. Ben-Joseph has received personal compensation for serving as an employee of Jazz Pharmaceuticals. Dr. Ben-Joseph has stock in Jazz Pharmaceuticals.
Virend Somers Virend Somers has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Jazz Pharmaceuticals. Virend Somers has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lilly. Virend Somers has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axome. Virend Somers has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ApniMed. The institution of Virend Somers has received research support from National Institutes Health.
Jed Black, MD (Jazz Pharmaceuticals) Jed Black, MD has received personal compensation for serving as an employee of Jazz Pharmaceuticals. Jed Black, MD has stock in Jazz Pharmaceuticals. Jed Black, MD has stock in .
No disclosure on file
Ragy Saad (Jazz Pharmaceuticals) No disclosure on file
Mat D. Davis Mat D. Davis has received personal compensation for serving as an employee of Teva pharmaceuticals. Mat D. Davis has received stock or an ownership interest from Teva Pharmaceuticals.
No disclosure on file
No disclosure on file
Weiyi Ni Weiyi Ni has received personal compensation for serving as an employee of Jazz Pharmaceuticals. An immediate family member of Weiyi Ni has received personal compensation for serving as an employee of LoanDepot. Weiyi Ni has stock in Jazz Pharmaceuticals. An immediate family member of Weiyi Ni has stock in LoanDepot.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file