Part of our coverage of the ADA 84th Scientific Sessions: Tirzepatide improves sleep apnoea episodes, both alone and in conjunction with CPAP, in people with OSA and obesity.
The dual GIP/GLP-1 receptor agonist tirzepatide shows promise as a treatment for obstructive sleep apnoea (OSA), both alone and in combination with continuous positive airway pressure (CPAP), according to findings presented at the 84th American Diabetes Association Scientific Sessions and published simultaneously in the New England Journal of Medicine.
SURMOUNT-OSA comprised two phase 3 trials of tirzepatide in people with moderate to severe OSA (apnoea–hypopnoea index [AHI] ≥15 events/hour) and obesity, but without diabetes. One trial enrolled people who were unable or unwilling to use CPAP, while the other included people on CPAP.
After 1 year of treatment with tirzepatide or placebo, both in addition to regular diet and lifestyle counselling sessions, AHI reduced from 53 to 28 events/hour in tirzepatide recipients who were not using CPAP, and from 46 to 17 events/hour in the CPAP group. In comparison, placebo recipients had significantly lesser reductions of around 5 events/hour.
Mean body weight was reduced by 18–20% in the tirzepatide groups, and there were significant reductions in systolic blood pressure and C-reactive protein levels. Patient-reported outcome measures showed significant improvements in sleep quality and daytime sleepiness; however, in an accompanying NEJM editorial, Patel (2024) cautions that the measurements used have not yet been validated for use in treatment studies and that the improvements were not necessarily clinically significant in their extent.
Adverse events were mostly gastrointestinal in nature and mostly occurred during tirzepatide dose escalation. Serious adverse events occurred in 7.5% of participants overall, with similar rates between the tirzepatide and placebo groups. Two confirmed cases of acute pancreatitis occurred in the tirzepatide group, and there were no cases of medullary thyroid cancer.
This study was limited by its short duration, and longer studies will be required to determine whether the observed improvements in AHI translate to improved clinical outcomes, including cardiovascular disease, over time. The ongoing SURMOUNT-Morbidity and Mortality in Obesity trial should shed further light on this.
Click here to read the study results in full.
Diabetes &
Primary Care
Issue:
Early View
Benefits of tirzepatide in obstructive sleep apnoea
The dual GIP/GLP-1 receptor agonist tirzepatide shows promise as a treatment for obstructive sleep apnoea (OSA), both alone and in combination with continuous positive airway pressure (CPAP), according to findings presented at the 84th American Diabetes Association Scientific Sessions and published simultaneously in the New England Journal of Medicine.
SURMOUNT-OSA comprised two phase 3 trials of tirzepatide in people with moderate to severe OSA (apnoea–hypopnoea index [AHI] ≥15 events/hour) and obesity, but without diabetes. One trial enrolled people who were unable or unwilling to use CPAP, while the other included people on CPAP.
After 1 year of treatment with tirzepatide or placebo, both in addition to regular diet and lifestyle counselling sessions, AHI reduced from 53 to 28 events/hour in tirzepatide recipients who were not using CPAP, and from 46 to 17 events/hour in the CPAP group. In comparison, placebo recipients had significantly lesser reductions of around 5 events/hour.
Mean body weight was reduced by 18–20% in the tirzepatide groups, and there were significant reductions in systolic blood pressure and C-reactive protein levels. Patient-reported outcome measures showed significant improvements in sleep quality and daytime sleepiness; however, in an accompanying NEJM editorial, Patel (2024) cautions that the measurements used have not yet been validated for use in treatment studies and that the improvements were not necessarily clinically significant in their extent.
Adverse events were mostly gastrointestinal in nature and mostly occurred during tirzepatide dose escalation. Serious adverse events occurred in 7.5% of participants overall, with similar rates between the tirzepatide and placebo groups. Two confirmed cases of acute pancreatitis occurred in the tirzepatide group, and there were no cases of medullary thyroid cancer.
This study was limited by its short duration, and longer studies will be required to determine whether the observed improvements in AHI translate to improved clinical outcomes, including cardiovascular disease, over time. The ongoing SURMOUNT-Morbidity and Mortality in Obesity trial should shed further light on this.
Click here to read the study results in full.
Patel SR (2024) Entering a new era in sleep-apnea treatment. N Engl J Med 21 Jun [Epub ahead of print] https://doi.org/10.1056/NEJMe2407117
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