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Executive Summary

First oral OX2R agonist to demonstrate efficacy across narcolepsy type 1, type 2, and idiopathic hypersomnia

ORX750

OX2R · OX2R agonist
Phase 2a (registrational start Q1 2026) Wholly-owned

Target: OX2R

Full NameOrexin Receptor 2
PathwayOrexin/Hypocretin signaling

Mechanism of Action

TypeSelective OX2R agonist (small molecule)
DescriptionORX750 is a potent, selective, orally bioavailable agonist of the orexin receptor 2 (OX2R). By directly activating OX2R, it mimics the wake-promoting effects of endogenous orexin, restoring the signal that is lost or impaired in narcolepsy and hypersomnia.
Indications: Narcolepsy Type 1 (NT1)Narcolepsy Type 2 (NT2)Idiopathic Hypersomnia (IH)

Target Biology

Orexin neurons in the hypothalamus produce orexin-A and orexin-B neuropeptides that bind to OX1R and OX2R receptors. OX2R activation promotes wakefulness, stabilizes sleep-wake transitions, and supports arousal. In narcolepsy type 1, orexin neurons are destroyed by autoimmunity, causing severe daytime sleepiness and cataplexy.

Human Genetic Evidence: Loss of orexin neurons causes narcolepsy type 1 with cataplexy

Clinical Data

No clinical trial data available.

Market Opportunity

Unmet Need: NT2 and IH are severely underserved. An oral, well-tolerated OX2R agonist could transform treatment paradigm.

Catalysts & Upcoming Events

EventTimingImportanceKey Metrics to WatchConsensus
Registrational program initiationQ1 2026criticalStudy design, endpoint selection, dose chosen for registrational study
Additional CRYSTAL-1 dose cohort data2026highHigher dose efficacy and safety to further characterize dose-response
Registrational program initiation (CRYSTAL registrational study)Q1 2026critical
Additional CRYSTAL-1 Phase 2a dose cohort data2026high
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