Jazz Pharmaceuticals to Present Expansive Research Demonstrating Comprehensive Treatment Benefits of Xywav® (calcium, magnesium, potassium, and sodium oxybates) in Sleep Conditions and Associated Comorbidities at SLEEP 2025
- Extensive research portfolio with 19 abstracts demonstrates strong commitment to sleep medicine research
- Multiple clinical trials (XYLO, DUET, CHIME, INTREPID, LYRICAL) showing positive treatment outcomes
- Low-sodium formulation addresses cardiovascular risks in patients
- AG˹ٷ-world data showing patient satisfaction and symptom improvements
- None.
Nineteen abstracts, including eleven late-breaking abstracts, underscore Jazz's leadership and extensive research in sleep medicine, and ongoing commitment to advancing the treatment of narcolepsy and idiopathic hypersomnia
For
Research to be presented at the meeting include dual late-breaking poster and oral presentations, which highlight the extensive Phase 4 data evaluating the effectiveness of low-sodium oxybate, Xywav®(calcium, magnesium, potassium, and sodium oxybates) oral solution in patients with narcolepsy and idiopathic hypersomnia (IH). These presentations include the first interim results from the open-label, single arm XYLO trial that evaluated ambulatory and office blood pressure changes in patients with narcolepsy after switching from a twice-nightly high-sodium oxybate oral solution to low-sodium oxybate, Xywav. Two additional presentations share novel results from the open-label, single arm DUET (Develop hypersomnia Understanding by Evaluating low-sodium oxybate Treatment) trial, which assessed Xywav on multiple sleep parameters, including the first presentation of polysomnography (PSG) outcomes in adults with IH. Additional data evaluated the effectiveness and safety of Xywav in a cohort of narcolepsy patients whose doses were optimized to greater than 9 grams (with twice-nightly dosing). The Xywav label recommends a maximum nightly dose of 9 grams per night.
"Jazz prioritizes a holistic approach to patient health, continuously deepening our understanding of how to support patients with challenging sleep disorders, as well as mitigate associated comorbidities," said Kelvin Tan, MB BCh, MRCPCH, chief medical affairs officer ofJazz Pharmaceuticals. "The extensive research presented at SLEEP 2025, underscores our commitment to patient-centric care, including the development of low-sodium Xywav, which is particularly important given the impact of sodium intake and existing cardiovascular risks among patients with narcolepsy or idiopathic hypersomnia."
Additional highlights at SLEEP 2025include:
- Two late-breaking poster presentations describing results from the CHIME study, which evaluated real-world, patient-reported outcomes, including treatment adherence, effectiveness, and satisfaction among adults with narcolepsy orIH (reported separately) taking Xywav.
- A late-breaking claims analysis that describes self-reported prevalence, severity, and impact of sleep inertia among individuals diagnosed with IH.
- Two additional late-breaking poster presentations showcasing findings from INTREPID, a retrospective cohort study that examinedOptum Market Clarity data from 2007�2023 to assess treatment patterns and changes in alerting agent claims among patients with narcolepsy or IH during the full study period and following the approval of Xywav.
- Two poster presentations showcasing sleep architecture results from the DUET trial, which demonstrated the effectiveness ofXywav on improvements in sleep quality among patients with IH or narcolepsy.
- Two poster presentations report interim results from the LYRICAL study, which examined real-world and patient-reported data showing patients in both the narcolepsy andIH cohorts taking Xywav experience symptom improvements, improved quality of life and high global treatment satisfaction.
TheSLEEP 2025abstractsareavailableonlineat .
A full list of Jazz Pharmaceuticals' presentations follows below:
ʰԳٲپDzվٱ | Lead Author | Presentation Type & Number / |
Dual Presentations | ||
Nocturnal Spontaneous Arousals in People | C Ruoff | Oral Presentation Session: LBA-02 (NON- Oral Presentation Date and Time: June 9, Poster #: 556 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 � |
Prevalence and Severity of Sleep Inertia Among Individuals With Idiopathic Hypersomnia | JK Alexander | Oral Presentation Session: LBA-02 (NON- Oral Presentation Date and Time: June 9, Poster #: 557 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 � |
Impact of Switching From High- to Low-Sodium Oxybate on Ambulatory Blood Pressure in Patients With Narcolepsy | VK Somers | Oral Presentation Session: LBA-02 (NON- Oral Presentation Date and Time: June 9, Poster #: 554 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 � |
Effectiveness and Safety of Low-Sodium Oxybate Dosages Greater Than 9 Grams in Study Participants With Narcolepsy | JH Simmons | Oral Presentation Session: LBA-02 (NON- Oral Presentation Date and Time: June 9, Poster #: 558 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 � |
Effectiveness and Safety of Low-Sodium Oxybate in Participants With Narcolepsy: Results From the DUET Study | LD Schneider | Oral Presentation Session: O-24 Oral Presentation Date and Time: June 11, 2025, 4:30 �4:45 p.m. Poster #: 393 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025,10:00 �11:45 AM |
Late-Breaking Presentations | ||
Sodium-Associated Comorbidity Risk Profiles in Individuals With Narcolepsy and Idiopathic Hypersomnia in the US | SC Markt | Poster #: 545 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
Narcolepsy Treatment Trends and Change in Alerting Agent Use After Low-Sodium Oxybate Initiation | SC Markt | Poster #: 551 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
Idiopathic Hypersomnia Treatment Trends and Change in Alerting Agent Use After Low-Sodium Oxybate Initiation | M Whalen | Poster #: 552 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
Social Determinants of Health and Clinical Burden in Narcolepsy: A Retrospective Cohort Analysis | A Zhou | Poster #: 533 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
AG˹ٷ-World Surveys of Treatment Effectiveness and Satisfaction in Adults With Narcolepsy Taking Low-Sodium Oxybate | J Yu | Poster #: 535 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
AG˹ٷ-World, Participant-Reported Effectiveness and Satisfaction with Low-Sodium Oxybate in Idiopathic Hypersomnia | J Yu | Poster #: 534 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
Demographic and Clinical Characteristics in Narcolepsy and Idiopathic Hypersomnia at Treatment Initiation | VK Somers | Poster #: 536 Poster Presentation Session: P-37 Session Date/Time: June 10, 2025,10:00 �11:45 a.m. |
Poster Presentations | ||
Effectiveness and Safety of Low-Sodium Oxybate in Idiopathic Hypersomnia Participants: Results From the DUET Study | DT Plante | Poster #: 413 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 a.m. |
Subjective Sleep Quality With Low-Sodium Oxybate Treatment in People With Narcolepsy: Results From the DUET Study | RB Sangal | Poster #: 422 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 a.m. |
Subjective Sleep Quality With Low-Sodium Oxybate Treatment in Idiopathic Hypersomnia: Results From the DUET Study | RK Bogan | Poster #: 414 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 a.m. |
Sleep Architecture With Low-Sodium Oxybate Treatment in Narcolepsy: Results From the DUET Study | C Ruoff | Poster #: 424 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 a.m. |
Sleep Architecture With Low-Sodium Oxybate Treatment in Idiopathic Hypersomnia: Results From the DUET Study | A Cairns | Poster #: 415 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 a.m. |
AG˹ٷ-World Experience and Satisfaction With Low-Sodium Oxybate in Narcolepsy: Interim Results From LYRICAL | C Drachenberg | Poster #: 420 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 a.m. |
AG˹ٷ-World Patient Insights on Low-Sodium Oxybate for Idiopathic Hypersomnia: Interim Results From LYRICAL | C Drachenberg | Poster #: 418 Poster Presentation Session: P-51 Session Date/Time: June 11, 2025, 10:00 �11:45 AM |
About Xywav®(calcium, magnesium, potassium, and sodium oxybates) oral solution
Xywavis the only low-sodium oxybate approved by theU.S. Food and Drug Administration(FDA) for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. The FDA recognized seven years of Orphan Drug Exclusivity forXywavfor the treatment of cataplexy or EDS in patients 7 years of age and older with narcolepsy. The Office of Orphan Product Development (OOPD) at the FDA also published its summary of clinical superiority findings forXywavfor the treatment of cataplexy or EDS in patients 7 years of age and older with narcolepsy by means of greater cardiovascular safety compared to Xyrem®(sodium oxybate) oral solution. The decision of the OOPD is based on the FDA findings thatXywavprovides a greatly reduced chronic sodium burden compared toXyrem.Xywavhas 131 mg of sodium at the maximum recommended nightly dosewhereas other high sodium oxybates have 1640 mg at the equivalent dose.Xywavis comprised of a unique composition of cations resulting in
Xywavis also the first and onlyU.S.FDA-approved treatment option for idiopathic hypersomnia in adults. The FDA recognized seven years of Orphan Drug Exclusivity forXywavfor the treatment of idiopathic hypersomnia in adults.Xywavis the only FDA-approved treatment studied across the multiple symptoms of idiopathic hypersomnia, such as EDS, sleep inertia (severe grogginess or confusion when waking up), long sleep duration and cognitive impairment.Xywavcan be administered as a twice- or once-nightly regimen for the treatment of idiopathic hypersomnia in adults.
The exact mechanism of action ofXywavin the treatment of adults with idiopathic hypersomnia and of cataplexy and EDS in narcolepsy is unknown. It is hypothesized that the therapeutic effects ofXywavare mediated through GABABactions during sleep at noradrenergic and dopaminergic neurons, as well as thalamocortical neurons.1TheU.S.Drug Enforcement Agency(DEA) has designatedXywavas a Schedule III medicine. The DEA defines Schedule III drugs, substances, or chemicals as drugs with a moderate to low potential for physical and psychological dependence.1,2Because of the risks of central nervous system (CNS) depression and abuse and misuse,Xywavis available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the XYWAV and XYREM REMS.
Important Safety Information for Xywav
WARNING: CENTRAL NERVOUS SYSTEM DEPRESSION and ABUSE AND MISUSE.
Because of the risks of CNS depression and abuse and misuse, XYWAV is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the XYWAV and XYREM REMS. |
Contraindications
XYWAViscontraindicated
- in combination with sedative hypnotics or alcohol and
- in patients withsuccinicsemialdehydedehydrogenasedeficiency.
Warnings and Precautions
Central Nervous System Depression
The concurrent use of XYWAV with other CNS depressants, including but not limited to opioid analgesics, benzodiazepines, sedating antidepressants or antipsychotics, sedating anti-epileptic drugs, general anesthetics, muscle relaxants, and/or illicit CNS depressants, may increase the risk of respiratory depression, hypotension, profound sedation, syncope, and death. If use of these CNS depressants in combination with XYWAV is required, dose reduction or discontinuation of one or more CNS depressants (including XYWAV) should be considered. In addition, if short-term use of an opioid (eg, post- or perioperative) is required, interruption of treatment with XYWAV should be considered.
Afterfirst initiating treatmentand until certain thatXYWAVdoes not affectthemadversely (eg, impairjudgment, thinking,or motor skills), cautionpatients againsthazardousactivitiesrequiring completemental alertnessor motorcoordinationsuch as operatinghazardousmachinery, includingautomobilesor airplanes. Also caution patients against these hazardous activities for at least 6 hours after takingXYWAV. Patientsshould be queriedabout CNS depression-related eventsupon initiationof XYWAVtherapyandperiodicallythereafter.
Abuse and Misuse
XYWAV is a Schedule Ill controlled substance. The active moiety of XYWAV is oxybate, also known asgamma-hydroxybutyrate (GHB), a ScheduleI controlled substance. Abuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death. The rapid onset of sedation, coupled with the amnestic features ofGHB particularly when combined with alcohol, has proven to be dangerous for the voluntary and involuntary user (eg, assault victim). Physicians should carefully evaluate patients for a history of drug abuse and follow such patients closely.
XYWAVandXYREMREMS
Because of the risks of central nervous system depression and abuse and misuse,XYWAV is available only through a restricted distribution program called the XYWAV and XYREM REMS.
NotablerequirementsoftheXYWAVandXYREMREMSinclude thefollowing:
- Healthcare Providers who prescribeXYWAVarespecially certified
- XYWAVwillbedispensedonlybythecentralpharmacy thatisspeciallycertified
- XYWAVwill be dispensedand shippedonly to patientswho are enrolled in the XYWAV andXYREMREMSwithdocumentationofsafeuse
Furtherinformationis availableator1-866-997-3688.
Respiratory Depression and Sleep-Disordered Breathing
XYWAV may impair respiratory drive, especially in patients with compromised respiratory function. Inoverdosesof oxybateandwith illicituse of GHB, life-threatening respiratory depressionhas beenreported. Increased apnea and reduced oxygenation may occur with XYWAV administration in adult andpediatricpatients. A significant increasein thenumberof central apneasand clinically significantoxygendesaturationmay occurin patients with obstructivesleep apneatreated with XYWAV. Prescribers should be aware that sleep-related breathing disorders tend to be more prevalent in obese patients, in men, in postmenopausal women not on hormone replacement therapy, and among patients with narcolepsy.
Depression andSuicidality
In Study 1, the randomized-withdrawal clinical trial in adult patients with narcolepsy (n=201), depressionand depressedmood were reported in
In Study 2, the randomized-withdrawal clinical trial in adult patients with idiopathic hypersomnia (n=154), depression and depressed mood were reported in
Two suicides and two attempted suicides occurred in adult clinical trials with oxybate (same active moiety as XYWAV). One patient experienced suicidal ideation and two patients reported depression in a pediatric clinical trial with oxybate. These events occurred in patients with and without previous histories of depressive disorders. The emergenceofdepressionin patients treatedwith XYWAV requires careful and immediateevaluation. Monitor patients for the emergence of increaseddepressivesymptoms and/or suicidalitywhiletakingXYWAV.
Other Behavioral or Psychiatric Adverse Reactions
InStudy 1,confusion and anxietyoccurredin
In Study 2, confusion and anxiety occurred in
Otherneuropsychiatricreactions reportedwith oxybate(sameactivemoiety as XYWAV)in adult or pediatric clinicaltrialsand in the postmarketing setting include hallucinations, paranoia, psychosis, aggression, agitation, confusion and anxiety. The emergence or increase in the occurrence of behavioral or psychiatric events in patients taking XYWAV shouldbecarefully monitored.
Parasomnias
ParasomniascanoccurinpatientstakingXYWAV.
In Study 1 and Study 2,parasomnias, including sleepwalking, were reported in
Inaclinical trialofXYREM(sameactive moietyasXYWAV) in adult patients with narcolepsy, five instances of sleepwalking with potential injury or significant injury were reported. Parasomnias, including sleepwalking, have been reported in a pediatric clinical trial with sodium oxybate(sameactivemoietyasXYWAV) andinpostmarketingexperiencewithsodiumoxybate.
Episodesofsleepwalkingshouldbefullyevaluatedandappropriateinterventionsconsidered.
Most Common Adverse Reactions
Themostcommon adversereactions (occurring in �
Inthepediatric clinicaltrialwithXYREM(sameactivemoietyasXYWAV) that included pediatric patients 7 to 17 years of age with narcolepsy, the most common adverse reactions (�
Additional Adverse Reactions
Adverse reactions that occurred in2-<
Adverse reactions that occurred in�
Discontinuation: In Study 1, 9 of 201 patients (
In the pediatric clinical trial with XYREM (same active moiety as XYWAV), 7 of 104 patients reported adverse reactions that led to withdrawal from the study (hallucination, tactile; suicidal ideation; weight decreased; sleep apnea syndrome; affect lability; anger, anxiety, depression; and headache).
Drug Interactions
XYWAV is contraindicated in combination with alcohol or sedative hypnotics. Use of other CNS depressantsmaypotentiatetheCNS-depressanteffects ofXYWAV.
Concomitantuse of sodiumoxybate with divalproexsodiumresults in an increase in systemicexposure toGHB, which was shown to cause a greater impairment on some tests of attention and working memory in a clinical study. A similar increase in exposure is expected with concomitant use ofXYWAV and divalproexsodium; therefore, an initial dose reduction of XYWAV is recommended when used concomitantly withdivalproexsodium. Prescribersare advisedto monitorpatientresponse closely and adjust dose accordinglyifconcomitantuseofXYWAVanddivalproexsodiumiswarranted.
Pregnancy and Lactation
There are no adequate data on the developmental risk associated with the use of XYWAV or sodiumoxybatein pregnant women. XYWAV should be used during pregnancyonly if the potential benefitjustifiesthepotentialrisktothefetus.GHB is excreted in human milk after oral administration of sodiumoxybate.There is insufficientinformationon the risk to a breastfed infant, and there is insufficientinformationon milkproductionin nursingmothers.Thedevelopmentalandhealthbenefits ofbreastfeeding should beconsidered along with the mother's clinical need for XYWAV and any potential adverse effects on the breastfed infantfrom XYWAVorfromtheunderlying maternalcondition.
Pediatric Use
Thesafety andeffectivenessofXYWAV for the treatment of cataplexy or excessive daytime sleepiness in pediatric patients 7 years of age and older with narcolepsy have been established. XYWAVhas not been studied in a pediatric clinical trial for narcolepsy orIH. Use ofXYWAV inpediatric patients 7 years of age and older with narcolepsy is supported by evidence from an adequate andwellcontrolledstudyofsodiumoxybate in pediatric patients 7 to 17 years of age, a study in adults showing a treatment effect of XYWAV similartothatobservedwithsodiumoxybate,pharmacokinetic dataof sodium oxybate from adult and pediatric patients, and pharmacokinetic dataof XYWAVfromhealthyadultvolunteers.
SafetyandeffectivenessofXYWAVinpediatricpatients belowtheageof7yearswith narcolepsy havenotbeenestablished.
Safety and effectiveness of XYWAV for the treatment of idiopathic hypersomnia in pediatric patients have not been established.
Geriatric Use
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of thedosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and ofconcomitantdisease orotherdrugtherapy.
Hepatic Impairment
ThestartingdoseofXYWAVshouldbereducedinpatientswithliverimpairment.
Dosage Modification in Patients with Hepatic Impairment:The recommended starting dosage in patients with hepatic impairment is one-half of the original dosage per night, administered orally, divided into two doses.
Dependence and Tolerance
Therehavebeencasereportsofwithdrawal,rangingfrommildtosevere,followingdiscontinuationofillict use of GHBat frequentrepeateddoses(18g to 250 g per day)in excessof the recommendeddosage range. Signs and symptomsof GHB withdrawal following abrupt discontinuation included insomnia, restlessness, anxiety, psychosis, lethargy, nausea, tremor, sweating, muscle cramps, tachycardia, headache, dizziness, rebound fatigue and sleepiness, confusion, and, particularly in the case of severe withdrawal, visual hallucinations, agitation, and delirium. These symptoms generally abated in 3 to 14 days. In cases of severe withdrawal, hospitalization may be required.
In the clinical trial experiencewithXYREM in narcolepsy/cataplexy patients at recommended doses, two patients reported anxiety and one reported insomnia following abrupt discontinuation at the termination of the clinical trial; in the two patients with anxiety, the frequency of cataplexy had increased markedly at the same time. In theXYWAV clinical trial in adult narcolepsy/cataplexy patients at recommended doses,one patientreported insomniafollowingabruptdiscontinuationofXYWAV. In the XYWAV clinical trial in adult idiopathic hypersomnia patients at recommended doses, six patients reported insomnia, two patients reported early insomnia, and one patient reported visual and auditory hallucinations following abrupt discontinuation of XYWAV.
Tolerance to XYWAV has not been systematically studied in controlled clinical trials. There have beensome case reports of symptoms of tolerance developing after illicit use at dosages far in excess of therecommendedXYWAVdosageregimen.
Please see full Prescribing Information, including BOXED Warning here:
About Jazz Pharmaceuticals
Jazz Pharmaceuticals plc (Nasdaq: JAZZ) is a global biopharma company whose purpose is to innovate to transform the lives of patients and their families. We are dedicated to developing potentially life-changing medicines for people with serious diseases � often with limited or no therapeutic options. We have a diverse portfolio of marketed medicines, including leading therapies for sleep disorders and epilepsy, and a growing portfolio of cancer treatments. Our patient-focused and science-driven approach powers pioneering research and development advancements across our robust pipeline of innovative therapeutics in oncology and neuroscience. Jazz is headquartered inDublin, Irelandwith research and development laboratories, manufacturing facilities and employees in multiple countries committed to serving patients worldwide. Please visit for more information.
Contacts:
Media:
Kristin Bhavnani
Head of Global Corporate Communications
Jazz Pharmaceuticals plc
[email protected]
Investors:
Jeff Macdonald
Executive Director, Investor Relations
Jazz Pharmaceuticals plc
[email protected]
References:
- Xywav (calcium, magnesium, potassium and sodium oxybates) oral solution. Prescribing Information.
Palo Alto, CA : Jazz Pharmaceuticals, Inc. 2021. - United States Drug Enforcement Agency. Drug Scheduling. . Accessed May 2025.
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