European guideline and expert statements on the management of narcolepsy in adults and children

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Bassetti , C L A , Kallweit , U , Vignatelli , L , Plazzi , G , Lecendreux , M , Baldin , E , Dolenc-Groselj , L , Jennum , P , Khatami , R , Manconi , M , Mayer , G , Partinen , M , Pollmaecher , T , Reading , P , Santamaria , J , Sonka , K , Dauvilliers , Y & Lammers , G J 2021 , ' European guideline and expert statements on the management of narcolepsy in adults and children ' , European Journal of Neurology , vol. 28 , no. 9 , pp. 2815-2830 . https://doi.org/10.1111/ene.14888

Title: European guideline and expert statements on the management of narcolepsy in adults and children
Author: Bassetti, Claudio L. A.; Kallweit, Ulf; Vignatelli, Luca; Plazzi, Giuseppe; Lecendreux, Michel; Baldin, Elisa; Dolenc-Groselj, Leja; Jennum, Poul; Khatami, Ramin; Manconi, Mauro; Mayer, Geert; Partinen, Markku; Pollmaecher, Thomas; Reading, Paul; Santamaria, Joan; Sonka, Karel; Dauvilliers, Yves; Lammers, Gert J.
Contributor: University of Helsinki, Department of Neurosciences
Date: 2021-09
Language: eng
Number of pages: 16
Belongs to series: European Journal of Neurology
ISSN: 1351-5101
URI: http://hdl.handle.net/10138/334008
Abstract: Background and purpose Narcolepsy is an uncommon hypothalamic disorder of presumed autoimmune origin that usually requires lifelong treatment. This paper aims to provide evidence-based guidelines for the management of narcolepsy in both adults and children. Methods The European Academy of Neurology (EAN), European Sleep Research Society (ESRS), and European Narcolepsy Network (EU-NN) nominated a task force of 18 narcolepsy specialists. According to the EAN recommendations, 10 relevant clinical questions were formulated in PICO format. Following a systematic review of the literature (performed in Fall 2018 and updated in July 2020) recommendations were developed according to the GRADE approach. Results A total of 10,247 references were evaluated, 308 studies were assessed and 155 finally included. The main recommendations can be summarized as follows: (i) excessive daytime sleepiness (EDS) in adults-scheduled naps, modafinil, pitolisant, sodium oxybate (SXB), solriamfetol (all strong); methylphenidate, amphetamine derivatives (both weak); (ii) cataplexy in adults-SXB, venlafaxine, clomipramine (all strong) and pitolisant (weak); (iii) EDS in children-scheduled naps, SXB (both strong), modafinil, methylphenidate, pitolisant, amphetamine derivatives (all weak); (iv) cataplexy in children-SXB (strong), antidepressants (weak). Treatment choices should be tailored to each patient's symptoms, comorbidities, tolerance and risk of potential drug interactions. Conclusion The management of narcolepsy involves non-pharmacological and pharmacological approaches with an increasing number of symptomatic treatment options for adults and children that have been studied in some detail.
Subject: cataplexy
European
guideline
management
narcolepsy
EXCESSIVE DAYTIME SLEEPINESS
QUALITY-OF-LIFE
ADMINISTERED SODIUM OXYBATE
ONSET CHILDHOOD NARCOLEPSY
GAMMA-HYDROXYBUTYRATE GHB
STEVENS-JOHNSON SYNDROME
PERIODIC LEG MOVEMENTS
ORAL JZP-110 ADX-N05
LONG-TERM USE
DOUBLE-BLIND
3112 Neurosciences
3124 Neurology and psychiatry
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