Summary of E2086 Presentation at World Sleep 2025 Company and Industry - **Company**: Eisai Co., Ltd. - **Industry**: Pharmaceutical, specifically focusing on neurology and sleep disorders Core Points and Arguments 1. **Introduction of E2086**: E2086 is a selective orexin receptor two agonist developed to treat narcolepsy type one, addressing the underlying orexin deficiency rather than just symptomatic treatment [12][34] 2. **Mechanism of Action**: E2086 acts on the orexin system in the brain, promoting wakefulness by stimulating orexin receptors, contrasting with Dayvigo (lemborexant), which is an orexin receptor antagonist [4][8] 3. **Clinical Trial Design**: The Phase 1b clinical trial was a multicenter, randomized, double-blind, five-period crossover study comparing E2086 at doses of 5, 10, and 25 mg against placebo and modafinil [14][20] 4. **Efficacy Results**: E2086 significantly extended sleep latency compared to placebo and modafinil across all doses tested, with effects lasting beyond seven hours post-administration [24][25][32] 5. **Safety Profile**: E2086 was generally well tolerated, with most treatment-emergent adverse events being mild to moderate, including increased urinary frequency, nausea, and dizziness [30][31] 6. **Future Development Plans**: Eisai plans to initiate Phase II studies for both narcolepsy type one and type two within the fiscal year, targeting submission for approval by fiscal 2028 [34] Additional Important Content 1. **Unique Development Approach**: Eisai has a unique position in developing both agonists and antagonists for the orexin system, which is not common in the industry [11] 2. **Comparison with Competitors**: The presentation highlighted the competitive landscape, noting that while Takeda is ahead in development, Eisai's once-daily dosing and safety profile could differentiate E2086 in the market [46][57] 3. **Potential for Broader Applications**: The company is considering expanding indications beyond narcolepsy to include idiopathic hypersomnia and other neurodegenerative diseases based on the orexin platform [75] 4. **Regulatory Considerations**: There are no current concerns regarding the scheduling of E2086 as a controlled substance, but ongoing studies will assess any potential for addictive properties [92][95] This summary encapsulates the key findings and strategic directions discussed during the presentation, emphasizing the innovative approach of Eisai in addressing sleep disorders through E2086.