Narcolepsy, a lifelong disorder, requires long-term treatment. It is often associated with multiple comorbidities, including significant cardiovascular conditions. One 2021 study published in Sleep was developed to estimate the incidence of cardiovascular comorbidities in adult patients with a narcolepsy diagnosis in the US.[i]
Methods
An administrative claims database was analyzed between January 2014 and June 2019. Eligible patients were ≥18 years and had continuous medical and prescription coverage (gaps <30 days allowed). The narcolepsy cohort was defined by ≥2 outpatient claims containing a diagnosis of narcolepsy type 1 or type 2 on separate days and no more than 6 months apart, with ≥1 non-diagnostic office-visit. Non-narcolepsy patients were matched 3:1 to narcolepsy patients by calendar date of cohort entry, age, gender, US geographic region, and insurance type. Each incidence calculation required a 6 month wash-out period prior to cohort entry. Differences between cohorts were evaluated using a Cox proportional hazard model adjusted for age, gender, region, insurance type, and relevant morbidities/comorbidities and medications in the baseline period.
Results
Of 54,239,110 adults in the database, 12,816 and 38,441 were included in the narcolepsy and matched non-narcolepsy cohort. Approximately 67% were female patients and mean age was approximately 38 years in both cohorts. Incidence rates (per 1,000 person-years) for newly recorded cardiovascular comorbidities or events in narcolepsy/non-narcolepsy were: cardiovascular disease without hypertension, heart failure, stroke, ischemic stroke, pulmonary edema, and a composite of stroke, atrial fibrillation, and pulmonary edema.
Conclusion
The study demonstrates the strong relationship between narcolepsy and cardiovascular disease and recommends that physicians should consider the increased cardiovascular risk when considering risk modification strategies and treatment options for narcolepsy patients.
In an associated offering, the American Academy of Cardiovascular Sleep Medicine will host a free webinar on this subject, presented by Dr. Viverend Somers, on July 18, 2023 at 7:30 p.m. EST. Further information may be found at July Webinar 1 (constantcontact.com).
Footnotes:
[i] Rami Ben-Joseph, Ragy Saad, Elizabeth Dabrowski, Ben Taylor, Sophia Gallucci, Virend Somers, Cardio-Vascular Burden of Narcolepsy Disease (CV-BOND): a Real-World Evidence Study. Sleep, Volume 44, Issue Supplement_2, May 2021, Page A198.
