Takeda and Alkermes disclosed encouraging Phase 3 and Phase 2 data for their orexin receptor 2-selective agonists, oveporexton and alixorexton, respectively, in treating narcolepsy type 1. Both drugs substantially improved wakefulness duration compared to placebo, with some differentiation in effect size and side effect profiles. These results escalate the competition for approval in a potentially multibillion-dollar market poised for the emergence of novel therapeutics targeting orexin pathways.