What’s next for narcolepsy

There’s a new therapeutic mechanism for narcolepsy nearing the market that comes closer to intervening in the disease’s causal biology than standard-of-care stimulants. The orexin 2 receptor agonist story is one of many emerging examples of how advances in medicinal chemistry are creating opportunities to more specifically drug the pathology of chronic diseases.

With therapies in the class now clearing Phase II and Phase III hurdles, the lingering questions include how tolerability will affect commercial success, which among the growing list of agonists will prove best in class, and how far the class’s potential may expand beyond its initial application in narcolepsy type 1...