• Feiyu Jiang, Hang Li, Yanting Chen, Haifeng Lu, Jianqiang Ni, and Gang Chen.
• Brain and Nerve Research Laboratory, Institute of Stroke Research, Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
• Medicine (Baltimore). 2023 Feb 17; 102 (7): e32754e32754.

BackgroundDaridorexant is a novel dual orexin receptor antagonist that has shown efficacy as a treatment for insomnia in multiple randomized clinical trials. However, the efficacy and safety of daridorexant for treatment of insomnia disorder has not been characterized comprehensively in the literature. Therefore, we performed a meta-analysis of available studies. We performed a meta-analysis to systematically evaluate the efficacy and safety of daridorexant for treatment of insomnia disorder.MethodsMEDLINE, Embase, Cochrane Library, and Clinicaltrials.gov for randomized controlled trials were systematically searched up to February 2022. Relative risk and standard mean difference were used to evaluate clinical outcomes.ResultsWe pooled 2271 patients from 4 randomized clinical trials, and evaluated efficacy endpoints. We found that 50 mg of daridorexant was superior to placebo for 4 efficacy outcomes including wake time after sleep onset, latency to persistent sleep, subjective total sleep time, and Insomnia Daytime Symptoms and Impacts Questionnaire domain score (P < .05). In addition, there were no significant differences (P > .05) in adverse events between daridorexant and placebo.ConclusionsDifferent dosages of daridorexant were tested for treatment of insomnia; however, 5 and 10 mg are not available because of issues of suboptimal effectiveness. Daridorexant showed better efficacy and safety for treatment of insomnia disorder at doses of 25 and 50 mg.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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