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Expert Interview

Slingshot members are talking to an expert! The topic is:

A look at Quviviq for treatment in adults with insomnia and how it compares to competitors in this space

Ticker(s): IDRSF, MRK

Who's the expert?

Institution: University of Miami Sleep Disorders Center

  • Board certified in Sleep Medicine and Neurology with Special Qualification in Child Neurology and the Medical Director of the Miami VA Healthcare system Sleep Disorders laboratory.
  • Areas of expertise include sleep disorders following traumatic brain injury, sleep disturbances, headaches, sleep apnea, snoring, insomnia and narcolepsy.
  • Clinicical research focus on sleep apnea and insomnia treatment adherence with an interest in the coexistence of sleep apnea and insomnia and how this complicates sleep disorders treatment.

Interview Questions

Can you please describe your clinical practice? 

Added By: sara_admin

What has been your clinical experience with Quviviq? How does it compare to Belsomra and Dayvigo and do you expect to switch any of your patients to Quviviq in the future?

Added By: sara_admin

How would you rank Quviviq (1-10)?

Added By: sara_admin

How do you manage patients with insomnia? What treatments do you give and in what sequence?
What percentage of patients progress to needing Orexin antagonist agents Belsomra or Dayvigo? 
Are these exclusively given 3rd line or later?  

Added By: user1ae2bf5f

What is the % split in terms of your Belsomra:Dayvigo prescribing for those who need Orexin agents.

What are the determining factors when deciding between them?

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What are the types of patients that might be best suited for Quviviq? 

Added By: user1ae2bf5f

Do patients typically take Belsomra/Dayvigo daily? Is that tolerable?  Or only intermittently?   Is there a need for a medication that can have more consistent dosing?

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How did you view the Phase 3 Trial results of Quviviq (daridorexant) as published in Lancet neurology?

MONTH 3, Placebo-adjustedWASO - Wake time after sleep onset50mg dose:     -18.3m
25 mg study 1: -11.9m25mg study 2:   -10.3m
LPS - latency to persistent sleepMONTH 3 placebo adjusted50mg dose:       -11.725mg study 1:   -7.625mg study 2:   -9.0
2ndary endpoint self reported total sleep time
month 3 placebo adjusted
50mg 19.8m25 mg 9.9mstudy 2 25 mg 19.1m

Added By: user1ae2bf5f

In the discussion they describe the change from baseline, regardless of placebo effect, combining the endpoints, they see about 1 hour total of improved sleep time.  Is this similar to what you'd expect from Belsomra/Dayvigo?

Added By: user1ae2bf5f

Was Quviviq differentiated from the class in terms of its safety profile?
Do you commonly observe side effects with Belsomra/Dayvigo?   Waketime sleepiness or next day effects?   Does this limit their use at all, and would this be a more compelling option?

Added By: user1ae2bf5f

Does IDSIQ benefit on daytime functioning set the drug apart from the class?

Added By: user1ae2bf5f

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