0460 First-line treatment patterns in patients with insomnia: a large-scale, real-world cohort study

Abstract Introduction Current pharmacologic treatments for insomnia are not universally effective, associated with a range of adverse events, can cause daytime impairment, and have the potential to be abused. With no consistent standard care, many patients experience multiple dose changes medication switches. The current study leveraged large-scale, real-world data investigate pharmacological treatment patterns insomnia. Methods Exploratory analyses were performed on claims from HealthVerity US primary care database. Data 10/2015 3/2020 obtained aged 18+. Prescribing patterns, including initial treatment, switching, concomitant discontinuation explored. Results Of approximately 1.4 million individuals, 265,382 (~19%) had an diagnosis 42.4% that group prescribed hypnotic medications. Among those, first prescriptions most frequently Z-drug (zolpidem, eszopiclone, zaleplon; 35.8%), trazodone (25.0%), benzodiazepine (15.6%), or another class (23.6%; includes orexin receptor antagonists, antidepressants, melatonin agonists, etc.). For those receiving first, median duration was 55 days, 80.4% subjects discontinued, 11.6% switched different medication, 7.9% received sleep medicine. Z-drug, 81 87.3% 8.2% switched, 4.4% treatment. 104 85.8% eventually 5.8% additional agent, 8.4% hypnotic. Furthermore, trazodone, 22% benzodiazepine, 31% 47% class. Conclusion These results demonstrate lack first-line approach insomnia; it is likely physicians their own preferences, they might tailor choice individual patient characteristics. Additionally, more discontinued medical than Further needed determine what proportion due successful versus being events efficacy. Support (If Any) Idorsia Pharmaceuticals, Ltd.