Oveporexton

Takeda is aiming for $2 billion to $3 billion in peak revenue for oveporexton as a treatment for narcolepsy type 1.\n Takeda and Alkermes both took data from their orexin receptor 2 (OX2R)-selective agonists to Singapore this morning as the race to get a new class of narcolepsy drugs approved heats up.Takeda assessed its drug, called oveporexton, in the FirstLight and RadiantLight phase 3 trials in more than 270 patients across 19 countries. Takeda announced back in July that the studies hit their primary endpoints of demonstrating statistically significant improvements in excessive daytime sleepiness as measured by the Maintenance of Wakefulness Test (MWT) across all doses of oveporexton tested when compared to placebo at Week 12.The pharma believes the secret to oveporexton’s success is its ability to mimic the body’s natural orexin cycle. Orexin is a neuropeptide lacking in patients with narcolepsy that helps regulate waking, wakefulness, appetite and energy.Now, the pharma has pulled back the curtain on the data for the phase 3 wins. Specifically, the majority of patients who were treated with the twice-daily 2-mg dose of oveporexton achieved wakefulness within what is considered the “normative range” as measured by the MWT, Takeda explained in a presentation at the World Sleep 2025 Congress in Singapore this morning.In addition, “close to” 85% of patients receiving this dosing regimen achieved a score on a separate sleepiness scale that was “comparable to healthy individuals,” Takeda noted.Median days with patients not experiencing cataplexy—a sudden loss of muscle control that is a defining symptom of narcolepsy type 1 (NT1)—rose from zero days at baseline to 4-5 days a week by Week 12.While the mean narcolepsy severity score among patients in both the FirstLight and RadiantLight studies began at around 30-31, by Week 12, this had dropped to a score of around 10, according to Takeda’s presentation.“More than 70% of participants [are] reporting the lowest severity level across doses,” the company pointed out. A total of 97% of patients reported improvements on a self-rated symptoms scale, Takeda added.The most common treatment-emergent adverse events (TEAEs) were insomnia, along with urinary frequency and urgency. There were no serious TEAEs in the RadiantLight study, and neither of the two TEAEs in FirstLight was deemed related to oveporexton.With Takeda on track to begin approval filings to the FDA and international regulators this fiscal year, the company is aiming for $2 billion to $3 billion in peak revenue potential for oveporexton as a treatment for NT1.The company initially has its eye on the U.S., where it is hoping oveporexton will “unlock the potential of a new era of care in NT1.”“We are excited to share these transformative results at World Sleep, which demonstrate the potential for a new era of care defined by multiple treatment measures that matter to patients,” Sarah Sheikh, head of the neuroscience therapeutic area unit and global development at Takeda, said in a release. Alkermes following close behind Alkermes is behind Takeda, having posted a phase 2 win for its own contender, alixorexton, just days after Takeda’s disclosure in July. Not to be outdone at the World Sleep 2025 Congress, Ireland-headquartered Alkermes also shared the data behind its midstage success at the same event.While Takeda’s oveporexton needs to be taken twice a day, Alkermes hailed its detailed results as the “first OX2R agonist to demonstrate clinically meaningful and statistically significant impact on wakefulness, cognition and fatigue with once-daily dosing.”Specifically, all alixorexton dose groups achieved “normative wakefulness” on the MWT, with observed mean sleep latency of approximately 24 minutes, 26 minutes and 28 minutes for the 4-mg, 6-mg and 8-mg doses, respectively.All doses evaluated resulted in “numerical and clinically meaningful improvements” in weekly cataplexy rates, with more than 40% of patients in the 6-mg and 8-mg cohorts seeing cataplexy disappear completely by Week 6.The safety profile appeared similar to oveporexton, with no serious TEAEs reported, while the most common TEAEs were frequent urination, insomnia, salivary hypersecretion and blurred vision.Assessing this drug class earlier in the year, William Blair analysts said experts they had spoken to suggested that urinary and insomnia issues “may be viewed as worthwhile trade-offs to patients.” For Alkermes, that still leaves blurred vision as a potential barrier, but the company stressed in its release that this was “mostly mild and intermittent and largely occurred and resolved within the first three days of treatment.”Alkermes certainly isn’t losing any sleep over the side effect profile, instead reaffirming its desire to take alixorexton into phase 3 in the first quarter of 2026.“These data represent a significant new contribution to the evidence base supporting the utility of orexin 2 receptor agonists in central disorders of hypersomnolence and support exploration of the broader therapeutic potential of the class across a range of psychiatric and neurological conditions,” Alkermes CEO Richard Pops said in a Sept. 8 release.Takeda may be in the lead, but close observers think there’s everything to play for. Back in March, Leerink analysts were pointing out that despite oveporexton’s “significant first-mover advantage,” the drug could still have a fight on its hands when compared to once-daily dosing options—of which Centessa Pharmaceuticals\' own OX2R agonist ORX750 is another player.Talking at a Goldman Sachs event in June, Pops said Takeda’s candidate is “proof of the pharmacology, but it’s an incomplete product.” Pops’ view reflected the fact Takeda’s molecule is given once in the morning and again a few hours later and is only on course to come to market in NT1.