Holistic treatment of OSA and obesity key to optimising cardiometabolic benefits of tirzepatide

Follow-up analyses of data from the SURMOUNT-OSA trial indicate that tirzepatide may reduce cardiometabolic risk by treating both obstructive sleep apnoea (OSA) and obesity. The researchers evaluated the impact of weight loss alone, reduction in OSA severity alone and the combination of the two.

OSA is a common disorder in which breathing repeatedly stops and starts during sleep because throat muscles relax and block the upper airway. As well as resulting in daytime tiredness and problems with concentration, OSA can have major cardiometabolic consequences. It associated with obesity, and weight reduction can notably improve OSA severity.  

Continuous positive airway pressure (CPAP) has been first-line therapy for OSA but is often poorly tolerated. As weight reduction yields notable OSA improvements in those who are obese, interest in tirzepatide as a treatment has grown owing to its effects on weight loss.

The SURMOUNT-OSA programme demonstrated that tirzepatide was superior to placebo in reducing OSA severity, both in CPAP users and non-users. Among participants with moderate-to-severe OSA and obesity, tirzepatide significantly reduced various cardiometabolic risk factors, including inflammation, prediabetes and triglycerides.

The secondary analyses sought to understand the drivers of these improvements by analysing the impact of weight loss alone, of changes in OSA severity alone and the combination of the two. While weight loss alone had marked effects, the benefits of combined weight loss and improvements in OSA were superior.

The findings support the idea that treating OSA and obesity in individuals with both conditions is required to optimise cardiometabolic benefits. In clinical practice, the treatment of OSA in people with obesity should include obesity management, with weight-loss therapies such as tirzepatide representing a potential option.

The full study, published in Nature Medicine, can be read here.