Alkermes and Takeda Pharmaceuticals reported encouraging data for their orexin agonist candidates targeting narcolepsy type 1. Alkermes’ Phase 2 trial of alixorexton showed significant increases in wakefulness duration but faced vision-related side effects. Takeda’s Phase 3 trials of oveporexton demonstrated substantial wakefulness improvements with a different safety profile. These developments intensify competition to establish the first approved orexin-based therapy in the multibillion-dollar sleep disorder market.