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

Autor: Bassetti CLA; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland., Kallweit U; Center for Narcolepsy/Hypersomnias, Clin. Sleep and Neuroimmunology, Institute of Immunology, University Witten/Herdecke, Witten, Germany., Vignatelli L; IRCCS, Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy., Plazzi G; IRCCS, Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy., Lecendreux M; AP-HP, Pediatric Sleep Center, CHU Robert-Debré, Paris, France.; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie-hypersomnie), Paris, France., Baldin E; IRCCS, Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy., Dolenc-Groselj L; Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.; Department of Neurology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Jennum P; Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Khatami R; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.; Center of Sleep Medicine, Sleep Research and Epileptology. Clinic Barmelweid, Barmelweid, Switzerland., Manconi M; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.; Sleep Center, Faculty of Biomedical Sciences, Neurocenter of Southern Switzerland, Università della Svizzera Italiana, Lugano, Switzerland., Mayer G; Neurology Department, Hephata Klinik, Schwalmstadt, Germany.; Department of Neurology, Philipps-Universität Marburg, Marburg, Germany., Partinen M; Department of Clinial Neurosciences, Clinicum, Helsinki Sleep Clinic, Vitalmed Research Center, Terveystalo Biobank and Clinical Research, University of Helsinki, Helsinki, Finland., Pollmächer T; Center for Mental Health, Klinikum Ingolstadt, Ingolstadt, Germany., Reading P; Department of Neurology, James Cook University Hospital, Middlesbrough, UK., Santamaria J; Neurology Service, Hospital Clínic of Barcelona, Barcelona, Spain., Sonka K; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic., Dauvilliers Y; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, University of Montpellier, INM INSERM, Montpellier, France., Lammers GJ; Sleep Wake Centre SEIN, Heemstede, The Netherlands.; Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2021 Sep; Vol. 28 (9), pp. 2815-2830. Date of Electronic Publication: 2021 Jun 25.
DOI: 10.1111/ene.14888
Abstrakt: Background and Aim: 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 in adults-scheduled naps, modafinil, pitolisant, sodium oxybate (SXB), solriamfetol (all strong), methylphenidate, amphetamine derivates (both weak); (ii) cataplexy in adults-SXB, venlafaxine, clomipramine (all strong) and pitolisant (weak); (iii) excessive daytime sleepiness in children-scheduled naps, SXB (both strong), modafinil, methylphenidate, pitolisant, amphetamine derivates (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.
(© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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