Tirzepatide Cuts OSA Severity by Nearly Two-Thirds in Obese Adults

In recent clinical trials, the drug tirzepatide has demonstrated significant potential in reducing the severity of obstructive sleep apnea (OSA) and aiding weight loss in adults with obesity. The SURMOUNT-OSA phase 3 trials, conducted by Eli Lilly and Company, revealed that tirzepatide injections led to a mean reduction in the apnea-hypopnea index (AHI) of up to 63%, which translates to approximately 30 fewer breathing events per hour. This improvement was observed in both participants with moderate-to-severe OSA who were not using positive airway pressure (PAP) therapy and those who were already on PAP therapy.
The first study in the trial series focused on adults with OSA and obesity who were not on PAP therapy. After 52 weeks, participants treated with tirzepatide experienced a mean AHI reduction of 27.4 events per hour, compared to 4.8 events per hour for those on a placebo. Additionally, tirzepatide contributed to a substantial mean body weight reduction of 18.1% from baseline, whereas the placebo group saw a reduction of only 1.3%.
The second study involved participants who were already using PAP therapy. Similar positive outcomes were observed, with a mean AHI reduction of 30.4 events per hour for the tirzepatide group versus 6.0 events per hour for the placebo group. The body weight reduction was also significant, with a mean reduction of 20.1% from baseline for the tirzepatide group, compared to 2.3% for the placebo group.
These results are particularly noteworthy given that the patient population was predominantly male, a demographic that typically achieves less weight loss with incretin therapy. OSA, a prevalent sleep-related breathing disorder, can lead to serious health issues such as hypertension, heart disease, and type 2 diabetes. The fact that 85% of OSA cases remain undiagnosed and untreated highlights the urgent need for effective treatment options.
Jeff Emmick, MD, Ph.D., senior vice president at Lilly, emphasized the importance of addressing this unmet medical need, stating that while there are treatments for the sleepiness associated with OSA, tirzepatide could be the first to target the root cause of the disease. The drug is already approved for chronic weight management under the brand names Zepbound® in the U.S. and Mounjaro® in select global markets.
The safety profile of tirzepatide was found to be consistent with previous trials, with the most common side effects being gastrointestinal-related and generally mild to moderate. The most frequently reported issues were diarrhea, nausea, and vomiting in the first study, and diarrhea, nausea, and constipation in the second.
The SURMOUNT-OSA trials' findings are set to be presented at the American Diabetes Association's 84th Scientific Sessions, and Lilly intends to submit the data for global regulatory review. If approved, tirzepatide could offer a new therapeutic approach for the millions of adults suffering from OSA and obesity.