Suvorexant for Reduction of Delirium in Older Adults After Hospitalization: A Randomized Clinical Trial

Suvorexant for Reduction of Delirium in Older Adults After Hospitalization: A Randomized Clinical Trial

Objective

To evaluate the orexin receptor antagonist suvorexant for reducing delirium in older adults at high risk for delirium after hospitalization.

Design and Participants

Double-blind, placebo-controlled, phase 3 randomized clinical trial conducted at 50 hospitals in Japan. Study population included Japanese adults aged 65 to 90 years at high risk for delirium and hospitalized for acute disease or elective surgery.

Intervention

Participants were randomized 1:1 to suvorexant (15 mg) or placebo taken at bedtime for up to 7 days while in the hospital.

Main Outcomes and Measures

Primary endpoint was the diagnosis of delirium according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria while participants were hospitalized. Treatment difference in the proportion of participants with delirium was analyzed.

Results

Study included 203 participants. Fewer participants taking suvorexant had delirium compared with placebo, but the difference was not statistically significant. Adverse events were similar between the 2 groups.

Conclusions and Relevance

Further studies are needed to determine whether suvorexant may be useful for reducing delirium in older adults at high risk for delirium after hospitalization.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04571944.

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