Key takeaways:

• The Brilliance Studies program consists of three 12-week, randomized, double-blind, placebo-controlled phase 3 studies evaluating once-daily and split-dose regimens of alixorexton.
• Alixorexton is a novel, investigational, oral, selective orexin 2 receptor agonist in development for the treatment of narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia.
• Primary endpoints for the studies will assess whether participants experience an increase in wakefulness, measured by the change in mean sleep latency on the maintenance of wakefulness test.

Alkermes plc has started the Brilliance Studies, a phase 3 clinical program evaluating the safety and efficacy of alixorexton compared to placebo in adults with narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2).

Alixorexton is the company’s investigational, oral, selective orexin 2 receptor (OX2R) agonist. It is currently in development for the treatment of NT1, NT2, and idiopathic hypersomnia. The drug previously received Breakthrough Therapy designation for the treatment of NT1 from the US Food and Drug Administration (FDA).

The Brilliance Studies program consists of three 12-week, randomized, double-blind, placebo-controlled phase 3 studies evaluating once-daily and split-dose regimens of alixorexton: Brilliance NT1 (Study 302 and Study 304) and Brilliance NT2 (Study 303).

• Brilliance NT1 Studies (Study 302 and Study 304): Participants in each Brilliance NT1 study will be randomized to receive one of two dosing regimens of alixorexton or placebo to be taken daily for 12 weeks. The primary endpoint of each study will assess whether participants taking alixorexton experience an increase in wakefulness compared to participants taking placebo, as measured by the change in mean sleep latency on the maintenance of wakefulness test (MWT). Secondary endpoints include change in Epworth Sleepiness Scale (ESS) score, mean weekly cataplexy rate, patient-reported outcomes related to fatigue, cognition and disease severity, and incidence of adverse events. Each study is expected to enroll approximately 150 patients with NT1 across sites in North America, Asia Pacific, and Europe.
• Brilliance NT2 Study (Study 303): Participants in the Brilliance NT2 study will be randomized to receive one of three dosing regimens of alixorexton or placebo to be taken daily for 12 weeks. The primary endpoint will assess whether participants taking alixorexton experience an increase in wakefulness compared to participants taking placebo alone, as measured by the change in mean sleep latency on the MWT. Secondary endpoints include change in ESS score, patient-reported outcomes related to fatigue, cognition and disease severity, and incidence of adverse events. The Brilliance NT2 study is expected to enroll approximately 180 patients with NT2 across sites in North America, Asia Pacific, and Europe.

“The initiation of the phase 3 Brilliance Studies program marks an exciting and important milestone for alixorexton. Building on the positive findings observed in our large phase 2 program across both narcolepsy type 1 and type 2, we are entering this pivotal stage with confidence. We look forward to evaluating alixorexton in both once-daily and split-dose regimens as we seek to optimize efficacy, safety, and dosing flexibility in the development of a potential new treatment option for patients and providers,” says Craig Hopkinson, MD, MBChB, chief medical officer and executive vice president of research and development at Alkermes, in a release.

Participants who complete one of the Brilliance Studies will be eligible to continue in a long-term, open-label, safety study.

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