SURWEY real-world study of solriamfetol: initiation, titration, safety, efficacy, and follow-up experience for patients with obstructive sleep apnea in Germany

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PurposeSolriamfetol is approved for use in the European Union to treat excessive daytime sleepiness (EDS) associated with obstructive sleep apnea (OSA). SURWEY characterized real-world evidence regarding physician initiation and titration strategies and patient experiences with solriamfetol. We report SURWEY data for patients with OSA and EDS in Germany (N = 83).MethodsSURWEY was a retrospective chart review conducted among physicians in Germany. Eligible patients were age ≥ 18 years who reached a stable solriamfetol dose and completed ≥ 6 weeks of treatment. Patients were grouped by solriamfetol initiation strategy: changeover, add-on, new-to-therapy.ResultsPatients’ mean (SD) age was 49 (14) years. New-to-therapy was the most common initiation strategy. Solriamfetol was initiated at 37.5 mg/day in most patients (n = 57, 69%) and titrated in 53 patients (64%); 30 (57%) completed titration within 2 weeks. In a post-hoc analysis, mean (SD) Epworth Sleepiness Scale (ESS) score was 16.0 (3.2) at baseline and decreased by 5.4 (3.6) at final follow-up (~ 16 weeks; p <.001). Improvement in patient- and physician-rated EDS was reported by ~ 90% of patients. Most patients (55%) reported effects of solriamfetol lasting ≥ 8 h; 91% of patients reported no change in nighttime sleep quality. The most frequent adverse events were headache (8%), decreased appetite (7%), and insomnia (6%).ConclusionMost patients in this study were new to therapy. Solriamfetol was typically initiated at 37.5 mg/day; titration was common. ESS scores improved with solriamfetol treatment, and most patients self-reported improvement in EDS symptoms. Common adverse events were consistent with those reported in previous clinical trials.