title: Suvorexant for the treatment of primary insomnia: A systematic review and meta-analysis.
abstract: Suvorexant is a dual orexin receptor agonist and is currently approved for the treatment of insomnia in the United States and Japan. We conducted a systematic review and meta-analysis to assess the efficacy and safety of suvorexant for the treatment of primary insomnia. We searched PubMed, EMBASE, and the Cochrane central register of controlled trials, contacted a relevant pharmaceutical company, and accessed websites of the U.S. Food and Drug Administration (FDA) and Pharmaceuticals and Medical Devices Agency (PMDA) for published and unpublished data. A total of four randomized trials involving 3076 patients with primary insomnia were included in our analysis. Our analysis suggested that suvorexant was associated with significant improvements in subjective time to sleep onset, subjective total sleep time, and subjective quality of sleep at 1 mo and 3 mo. Somnolence, fatigue, and abnormal dreams were the most common adverse effects. We concluded that suvorexant was associated with improvement in some sleep parameters and some adverse effects. To determine the place of suvorexant in the treatment of insomnia, comparative effectiveness trials are needed.
authors.affiliation: Department of General Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: akira.kuriyama.jpn@gmail.com.
authors.forename: Akira
authors.initials: A
authors.lastname: Kuriyama
authors.affiliation: Department of Neurology, Kurashiki Central Hospital, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Tabata
mesh_terms: D001381:Azepines / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D016032:Randomized Controlled Trials as Topic; D000068776:Sleep Aids, Pharmaceutical / Q000009:adverse effects / Q000627:therapeutic use*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D014481:United States
chemical_list: D001381:Azepines; D000068776:Sleep Aids, Pharmaceutical; D014230:Triazoles; C551624:suvorexant
keywords: Abnormal dreams; Belsomra; Insomnia; Meta-analysis; Primary insomnia; REM sleep behavior disorder; Randomized controlled trials; Suvorexant; Systematic review