1、Equity ResearchIndustry Update September 2,2025BiotechnologyNarcolepsy Deep DiveWill ORX2 Work If Orexin Levels Are Normal?Will Tox Emerge?Our CallWere bullish on the orexin class and see ALKS&CNTA as well positioned in NT2(unseating Takeda in NT1 will be tough).We think OX2R will work in NT2 and wh

2、ile risk of visual tox is high,expect cases will be mild¬ hamper the commercial oppy.Both ALKS and CNTA have near-term clinical catalysts that we think could re-rate shares.Both companies,along with Takeda(not covered),are developing oral formulations of orexin-2 receptor(OX2R)agonists for the tr

3、eatment of sleeping disorders:narcolepsy type 1(NT1),narcolepsy type 2(NT2),and idiopathic hypersomnia(IH).Near-Term catalysts:World Sleep(Sept.5-10,2025):Ph3 Takeda data in NT1,Ph2 ALKS data in NT1Fall 2025:Ph2 ALKS data in NT22025:Ph2 CNTA data in NT1,NT2,and IHWe think NT2 and IH updates will sig

4、nificantly impact how investors think about the peak sales opportunity for ALKS and CNTA.We think all 3 opportunities could potentially be large,but that Takedas lead in NT1 makes it difficult for investors to model high market share to ALKS/CNTA in this category.Takeda is behind in NT2 and IH,and t

5、hus we think good data here could unlock substantially more value for ALKS and CNTA.Our deep dive focuses on NT2,as Vibrance-2 top line is a near-term event.Key questions interrogated in this report:Key Question#1:Will orexin-2 agonists updates in NT2 be positive?(pg.5)Key Question#2:Will more visua

6、l tox emerge?(pg.22)Key Question#3:How do we think about the narcolepsy market?(pg.34)What is Narcolepsy?A brief primer(pg.41)The history of narcolepsy treatments(pg.50)Were bullish on OX2R agonism(alixorexton and ORX750)in NT2.We think healthy volunteer data from CNTA and ALKS imply that the MOA is