Page 84 - The autoimmune hypothesis of narcolepsy and its unexplored clinical features M.S. Schinkelshoek

Chapter 5
Abstract
Narcolepsy type 1 patients is characterized by an increase in body weight after disease onset, frequently leading to obesity. It was suggested that this weight gain may be counteracted by treatment with sodium oxybate (SXB). We here provide longitudinal BMI data of patients with narcolepsy type 1 after starting treatment with SXB, compared to patients in whom treatment with modafinil was initiated. 81 individuals with narcolepsy type 1 fulfilled the entry criteria for this retrospective study: 59 had newly started treatment with SXB, and 22 had newly started modafinil. Gender-specific differences between both treatment groups were compared using Student’s t-tests and mixed effect modeling. Patients using SXB lost weight with a mean BMI decrease of 2.56 kg/m2 between the first and last measurement (women; p=0.001) and 0.84 kg/ m2 (men; p=0.006). Patients using modafinil, however, gained weight with a mean BMI increase of 0.57 kg/m2 (women; p = 0.033) and 0.67 kg/ m2 (men; p=0.122). Medication (p=0.006) and baseline BMI (p=0.032) were predictors for BMI decrease. In conclusion, treatment with SXB is associated with a BMI reduction in narcolepsy type 1, while modafinil treatment is not. This effect is most pronounced in those who already have a higher baseline BMI.
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