ADA: Tirzepatide Lowers Apnea-Hypopnea Index in Moderate-to-Severe OSA

On Wednesday, June 26, 2024, a study revealed that tirzepatide significantly reduces the apnea-hypopnea index (AHI) in individuals suffering from moderate-to-severe obstructive sleep apnea and obesity. This research, published online on June 21 in the New England Journal of Medicine, was synchronized with the annual meeting of the American Diabetes Association, held from June 21 to 24 in Orlando, Florida.

The study was led by Dr. Atul Malhotra from the University of California, San Diego, alongside his colleagues. They conducted two phase 3 trials targeting adults with moderate-to-severe obstructive sleep apnea and obesity. The first trial included participants who were not receiving positive airway pressure (PAP) therapy at the start, while the second trial focused on those who were already undergoing PAP therapy at baseline. Participants in both trials were randomly assigned to receive either a maximum tolerated dose of tirzepatide (10 or 15 mg) or a placebo for a duration of 52 weeks.

In the first trial, the research team observed that the mean change in AHI was −25.3 events per hour for those taking tirzepatide, compared to −5.3 events per hour for the placebo group at the 52-week mark. This resulted in an estimated treatment difference of −20.0 events per hour. In the second trial, the mean change in AHI was −29.3 events per hour for the tirzepatide group, compared to −5.5 events per hour for the placebo group, leading to an estimated treatment difference of −23.8 events per hour. Significant improvements were noted with tirzepatide for all prespecified key secondary endpoints.

The authors of the study noted that participants who received tirzepatide experienced a clinically meaningful improvement in sleep-disordered breathing. Additionally, these participants reported alleviated sleep disturbances and sleep-related impairments. There were also reductions in common cardiovascular risk factors associated with obstructive sleep apnea.

While the study showed promising results, it is important to note that several authors disclosed connections to biopharmaceutical companies, including Eli Lilly, which is the manufacturer of tirzepatide and also funded the study.