Can once-daily oral alixorexton, an orexin 2 receptor agonist, restore wakefulness and reduce cataplexy in adults with narcolepsy type 1?
Can once-daily oral alixorexton, an orexin 2 receptor agonist, restore wakefulness and reduce cataplexy in adults with narcolepsy type 1?
VIBRANCE-1
Safety, tolerability, and efficacy of alixorexton, a selective orexin 2 receptor agonist for narcolepsy type 1 (Vibrance-1): a randomised, double-blind, placebo-controlled, phase 2 trial
The Lancet Neurology · 2026
Bottom Line: Once-daily oral alixorexton (4, 6, or 8 mg) produced large, clinically meaningful improvements in wakefulness, daytime sleepiness, and (at 6 mg) cataplexy over 6 weeks in narcolepsy type 1, with mean MWT sleep latency and ESS scores reaching normative ranges; it was generally well tolerated with on-target OX2R adverse events…