Insights on Vibrance-2 Study Results of Alixorexton in Narcolepsy Type 2: Richard K. Bogan, MD, FCCP, FAASM

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"Orexin is the main neuropeptide. It’s the command-and-control center for wakefulness. Downstream regions of the brain respond to orexin to produce other monoaminergic amines that create state stability and keep us awake."

Alixorexton (Alkermes) is an investigational oral selective orexin 2 receptor agonist being evaluated for the treatment of narcolepsy type 1, narcolepsy type 2 (NT2), and idiopathic hypersomnia. Orexin is a neuropeptide produced in the lateral hypothalamus that plays a key role in regulating wakefulness through activation of multiple downstream wake-promoting pathways distributed throughout the brain. In new data from the phase 2 Vibrance-2 study (NCT06555783) presented at the 2026 SLEEP Annual Meeting, held June 14-17 in Baltimore, Maryland, the agent met the study’s dual primary end points in adults living with NT2.¹

For context, Vibrance-2 was a phase 2, randomized, double-blind, placebo-controlled, dose-ranging trial that evaluated once-daily alixorexton at doses of 10 mg, 14 mg, or 18 mg vs placebo for 8 weeks in 93 patients with NT2. The study’s dual primary end points assessed changes from baseline to week 8 in mean sleep latency on the Maintenance of Wakefulness Test and changes from baseline to week 8 in Epworth Sleepiness Scale scores, comparing participants treated with alixorexton with those receiving placebo.

In an interview with NeurologyLive^® at SLEEP 2026, sleep expert Richard K. Bogan, MD, FCCP, FAASM,an associate clinical professor at the University of South Carolina School of Medicine, reviewed the emerging role of orexin-targeted therapies in managing excessive daytime sleepiness, with focusing on individuals with NT2. He further discussed the design and early findings of the phase 2, placebo-controlled, dose-finding Vibrance-2 study of alixorexton, highlighting improvements in both objective and subjective measures of sleepiness, as well as signals in related domains such as fatigue and executive function.

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REFERENCES
1. Alkermes Presents Detailed Positive Results From Vibrance-2 Phase 2 Study of Alixorexton in Adults With Narcolepsy Type 2 at SLEEP 2026. News release. Alkermes. June 17, 2026. Accessed June 19, 2026. https://investor.alkermes.com/news-releases/news-release-details/alkermes-presents-detailed-positive-results-vibrance-2-phase-2