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Wake Up To NEW EXPERIENCES

Efficacy1-4

DAYVIGO was assessed across 2 pivotal trials, including nearly 2000 adult patients

SUNRISE 1 : DAYVIGO vs Zolpidem ER & Placebo

SUNRISE 2 : DAYVIGO vs Placebo

Help Patients Fall Asleep Faster and Stay Asleep Longer1-4

DAYVIGO was assessed vs placebo across 2 pivotal trials including nearly 2000 adult patients. Studies measured sleep onset and maintenance at Month 1 (sleep labs) and Month 6 (patient diaries).

At the proven starting dose of 5 mg, and at 10 mg, DAYVIGO was demonstrated superior to placebo across 2 pivotal trials.

Polysomnography (PSG) Measures2

Latency to Persistent Sleep (LPS)

minutes from lights off to the first epoch of 20 consecutive (30-second) epochs of non-wakefulness

Sleep Efficiency (SEF)

proportion of time spent asleep per Time in Bed (TIB), calculated as Total Sleep Time (TST)/interval from lights off until lights on

Wake After Sleep Onset (WASO)

minutes of wake from the onset of persistent sleep until lights on

WASO During 2nd Half of the Night (WASO2H)

minutes of wake during the interval from 240 minutes after lights off until lights on

Subjective Measures (subject-reported via sleep diary)2-4

Subjective Sleep Onset Latency (sSOL)

estimated minutes from the time that the subject attempted to sleep until sleep onset

Subjective Sleep Efficiency (sSEF)

pproportion of subjective total sleep time per subjective time spent in bed

Subjective WASO (sWASO)

sum of estimated minutes of wake during the night after initial sleep onset until the time the subject stopped trying to sleep for the night, operationalized as the time the subject got out of bed for the day

Pie chart
Pie chart legend

sleep onset

DAYVIGO Reduced Time to Sleep Onset

Time to sleep onset measures the amount of time it takes patients to fall asleep.

SUNRISE 1 (sleep labs)2

DAYVIGO reduced time to sleep onset, as assessed by the primary endpoint (mean* change from baseline in LPS vs placebo at Month 1).

Bar Graph

SUNRISE 2 (patient diaries)3

DAYVIGO reduced time to sleep onset, asassessed by the primary endpoint (mean* change from baseline in sSOL vs placebo at Month 6).

Bar Graph

LPS=latency to persistent sleep; sSOL=subjective sleep onset latency.

* For the sleep onset endpoints (LPS, sSOL), the mean refers to least squares geometric mean, which was used due to the approximately log normal distribution of the outcomes.

‡ Treatment effect refers to the ratio of [Day 29/30 LPS / Baseline LPS] or [Month 6 sSOL / Baseline sSOL] for DAYVIGO vs placebo, such that a smaller ratio corresponds to a greater improvement.

Sunrise 1

Sleep Onset With DAYVIGO vs Active Comparator and Placebo Through Month 12

Key primary endpoint: Mean* change from baseline in LPS at Month 1 for DAYVIGO 5 mg and 10 mg compared to placebo.

Prespecified exploratory endpoints: Mean* change from baseline in LPS at Month 1 for DAYVIGO 5 mg and 10 mg compared to zolpidem ER. Mean* change from baseline in LPS at Day 1/2 for DAYVIGO 5 mg and 10 mg compared to placebo and zolpidem ER.

Sleep Onset

ER=extended release;

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance. These data are not intended to imply the superiority of DAYVIGO vs zolpidem ER.

Sunrise 2

Subjective Sleep Onset With DAYVIGO vs Placebo Through Month 63

Key primary endpoint: Mean* change from baseline in LPS at Month 1 for DAYVIGO 5 mg and 10 mg compared to placebo.

Prespecified exploratory endpoints: Mean* change from baseline in LPS at Month 1 for DAYVIGO 5 mg and 10 mg compared to zolpidem ER. Mean* change from baseline in LPS at Day 1/2 for DAYVIGO 5 mg and 10 mg compared to placebo and zolpidem ER.

Overtime Graph

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance.

LPS=latency to persistent sleep; sSOL=subjective sleep onset latency.

* For the sleep onset endpoints (LPS, sSOL), the mean refers to least squares geometric mean, which was used due to the approximately log normal distribution of the outcomes.

sleep maintenance

DAYVIGO Reduced Wake After Sleep Onset (WASO)

WASO measures the amount of time spent awake after initially falling asleep.

SUNRISE 1 (sleep labs)2

DAYVIGO reduced WASO, as assessed by the secondary endpoint (mean* change from baseline in WASO vs placebo at Month 1).

WASO Chart

SUNRISE 2 (patient diaries)3

DAYVIGO reduced sWASO, as assessed by the secondary endpoint (mean* change from baseline in sWASO vs placebo at Month 6).

Patient Diaries

sWASO=subjective wake after sleep onset; WASO=wake after sleep onset.

* For sleep maintenance endpoints (WASO, sWASO), the mean refers to least squares mean.

Sunrise 1

WASO With DAYVIGO vs Active Comparator and Placebo Through Month 12

Key secondary endpoint: Mean change from baseline in WASO at Month 1 for DAYVIGO 5 mg and 10 mg compared to placebo.

Prespecified exploratory endpoints: Mean change from baseline in WASO at Month 1 for DAYVIGO vs zolpidem ER. Mean change from baseline in WASO at Day 1/2 for DAYVIGO vs placebo and zolpidem ER.

WASO Over Time

ER=extended release;

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance. These data are not intended to imply the superiority of DAYVIGO vs zolpidem ER.

Sunrise 2

sWASO with DAYVIGO vs Placebo Through Month 63

Key primary endpoint: Mean change from baseline in sWASO at Month 6 for DAYVIGO 5 mg and 10 mg compared to placebo.

Prespecified exploratory endpoints: Mean change from baseline in sWASO at First 7 Days, Month 1, and Month 3 for DAYVIGO vs placebo.

sWASO overtime

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance.

ER=extended release; sWASO=subjective wake after sleep onset; WASO=wake after sleep onset.

* For sleep maintenance endpoints (WASO, sWASO), the mean refers to least squares mean.

DAYVIGO Improved Sleep Efficiency (SEF) in Clinical Trials

SEF is measured by the amount of time spent asleep divided by the total time spent in bed.

SUNRISE 1 (sleep labs)2

DAYVIGO increased SEF, as assessed by the secondary endpoint (mean* change from baseline in SEF vs placebo at Month 1).

WASO sleep lab

SUNRISE 2 (patient diaries)3

DAYVIGO increased sSEF, as assessed by the secondary endpoint (mean* change from baseline in sSEF vs placebo at Month 6).

Patient Diaries

SEF=sleep efficiency; sSEF=subjective sleep efficiency.

SEF=sleep efficiency; sSEF=subjective sleep efficiency.

Sunrise 1

SEF With DAYVIGO vs Active Comparator and Placebo Through Month 12

Key secondary endpoint: Mean change from baseline in SEF at Month 1 for DAYVIGO 5 mg and 10 mg compared to placebo.

Prespecified exploratory endpoints: Mean change from baseline in SEF at Month 1 for DAYVIGO vs Zolpidem ER. Mean change from baseline in SEF at Day 1/2 for DAYVIGO vs placebo and zolpidem ER.

WASO Over Time

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance. These data were not intended to imply the superiority of DAYVIGO vs Zolpidem ER.

Sunrise 2

sSEF With DAYVIGO vs Placebo Through Month 63

Key primary endpoint: Mean change from baseline in sSEF at Month 6 for DAYVIGO 5 mg and 10 mg compared to placebo.

Prespecified exploratory endpoints: Mean change from baseline in sSEF to First 7 Days, Month 1, and Month 3 for DAYVIGO vs placebo.

sWASO overtime

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance.

ER=extended release; SEF=sleep efficiency; sSEF=subjective sleep efficiency.

* For sleep maintenance endpoints (SEF, sSEF), the mean refers to least squares mean.

6-Month Parallel-Group Extension Period4

Prespecified exploratory endpoints: Mean change from baseline in sSEF to First 7 Days, Month 1, and Month 3 for DAYVIGO vs placebo.

Sunrise 2

The initial 6-month placebo-controlled treatment period was followed by a 6-month parallel-group extension period.

At the start of the extension period, patients taking DAYVIGO in the 6-month placebo-controlled study continued on their previous dose of DAYVIGO during the 6-month parallel-group extension period. Patients on placebo during the 6-month placebo-controlled study were re-randomized to either DAYVIGO 5 mg or 10 mg.

sWASO overtime

sSEF Over Time6 (Placebo Patients Re-Randomized to DAYVIGO )

The placebo group during the 6-month placebo-controlled study re-randomized to DAYVIGO 5mg (n=128) and 10 mg (n=122) at the start of the extension period showed baseline sSEF values at Month 6 (0 months of DAYVIGO exposure) of 70.5% and 71.1%, respectively. The mean change from baseline, sSEF measures at Month 9 (3 months of DAYVIGO exposure) are 4.7% (5 mg), 5.1% (10 mg) and at Month 12 (6 months of DAYVIGO exposure) are 3.9% (5 mg) and 4.5% (10 mg).

Limitations:Prespecified exploratory endpoints were not adjusted for multiplicity and were not adequately powered to show statistical significance. Extension period did not include a placebo comparator and was therefore not designed to draw efficacy conclusions.5

Sleep Efficacy
The effect of DAYVIGO at first use were generally consistent with later timepoints.1
Evaluation across subgroups by age, race, sex and BMI suggested no differences in response of DAYVIGO. 1,7

Studied in a Variety of Patients With Insomnia2-4

Nearly 2000 patients with insomnia disorder participated in the SUNRISE 1 and SUNRISE 2 clinical trials—multicenter, randomized, double-blind, placebo-controlled trials.

Sunrise 1

Polysomnography (sleep labs)

Sleep diaries (patient reports)

N=1006

1-month treatment period

Treatment arms

DAYVIGO 5 mg

DAYVIGO 10 mg

Active comparator (zolpidem ER 6.25 mg) Placebo

Males ≥65 years of age

Females ≥55 years of age

Median age: 63.0 years

86.0% female

27.0% non-white

45.0% ≥65 years of age

Sunrise 2

Sleep diaries (patient reports)

N=971

6-month placebo-controlled treatment period with6-month parallel-group extension period

Treatment arms

DAYVIGO 5 mg

DAYVIGO 10 mg

Placebo

Adults ≥18 years of age

Median age: 55.0 years

68.0% female

28.5% non-white

28.0% ≥65 years of age

All patients received instructions consistent with principles of good sleep hygiene.

The SUNRISE pivotal trials:

Studied insomnia disorder using the most recent DSM-5 diagnostic criteria, including:
Difficulty initiating, maintaining, or returning to sleep 3 days/week for at least 3 months
A complaint of clinically significant daytime impairment despite adequate opportunity for sleep
Included patients with diverse medical histories or who had medical conditions that were concurrently treated or controlled for, including :
Major depressive disorder
Generalized anxiety disorder
Migraines
Hypertension
Menopause
Diabetes
Excluded patients with certain concurrent medical conditions, such as :
Narcolepsy
Periodic limb movement disorder
Reported history of complex sleep-related behaviors
Restless leg syndrome
Sleep related breathing disorder
Moderate to severe symptoms of depression or anxiet
Circadian rhythm sleep disorder

BMI=body mass index; DSM-5=Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

References:

  1. Dayvigo (Lemborexant) India Prescribing Information: 2021.
  2. Rosenberg R, Murphy P, Zammit G, et al. Comparison of Lemborexant With Placebo and Zolpidem Tartrate Extended Release for the Treatment of Older Adults With Insomnia Disorder: A Phase 3 Randomized Clinical Trial. JAMA Netw Open. 2019;2(12):e1918254.
  3. Kärppä M, Yardley J, Pinner K, Filippov G, Zammit G, Moline M, Perdomo C, Inoue Y, Ishikawa K, Kubota N. Long-term efficacy and tolerability of lemborexant compared with placebo in adults with insomnia disorder: results from the phase 3 randomized clinical trial SUNRISE 2. Sleep. 2020;43(9):zsaa123.
  4. Yardley J, Kärppä M, Inoue Y, Pinner K, Perdomo C, Ishikawa K, Filippov G, Kubota N, Moline M. Long-term effectiveness and safety of lemborexant in adults with insomnia disorder: results from a phase 3 randomized clinical trial. Sleep Med. 2021 Apr;80:333-342.