Retrospective Study of the Early-Period Safety After Introducing Lemborexant: A Stratified Analysis By Age

Insomnia is one of the most common sleep disorders and is frequently observed in older patients. It is recommended that older patients select hypnotics considering the adverse events owing to increased sensitivity to hypnotics and their prolonged effect. Lemborexant (LEM), an orexin receptor antagonist, has a low potential dependence and a low risk of fall, rebound insomnia, and withdrawal, such as benzodiazepines; therefore, it is considered as one of safety pharmacological treatments of insomnia in older patients. We retrospectively conducted a stratified analysis by age for the safety of LEM in real-world practice. A total of 224 inpatients from Nagoya University Hospital who were prescribed with LEM from September 1, 2020 to December 31, 2021, were analyzed. These patients were divided into 117 general adult patients (18 – 64 years), 60 young-old patients (65 – 74 years), and 47 old-old patients (over 75 years). The rate of LEM prescription discontinuation owing to adverse events was 4.3％ in general adult patients, 5.0％ in young-old patients, and 8.5％ in old-old patients; there was no significant difference among the three groups. The all-adverse events rate after introducing LEM was 22.2％ in general adult patients, 18.3％ in young-old patients, and 27.7％ in old-old patients; there was no significant difference among the three groups. This study revealed that there was no difference in the rate of LEM prescription discontinuation owing to adverse events during the early period after LEM initiation among the three groups.