Sleep medicine · Treating the obesity rather than the airway
Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity
| Design | Two phase 3, double-blind, placebo-controlled trials |
|---|---|
| Treatment | Tirzepatide |
| Control | Placebo |
| Population | Adults with moderate-to-severe obstructive sleep apnoea and obesity; mean baseline AHI 51.5 and 49.5 events per hour, mean BMI 39.1 and 38.7 |
| Follow-up | 52 weeks |
| Primary endpoint | Change in apnoea-hypopnoea index at week 52 |
| Result | In trial 1 the AHI fell by 25.3 events per hour (95% CI -29.3 to -21.2) with tirzepatide versus 5.3 (-9.4 to -1.1) with placebo. Body weight, hypoxic burden, hsCRP and systolic blood pressure all fell, and sleep-related patient-reported outcomes improved. |
| Secondary endpoints | Body weight, hypoxic burden, hsCRP, systolic blood pressure, patient-reported sleep outcomes |
Among persons with moderate-to-severe obstructive sleep apnea and obesity, tirzepatide reduced the AHI, body weight, hypoxic burden, hsCRP concentration, and systolic blood pressure and improved sleep-related patient-reported outcomes.
The trial authors, in the published abstract
Reframes obstructive sleep apnoea in obesity as a treatable metabolic disease rather than a purely mechanical one. Halving the AHI with a drug, alongside falls in blood pressure and inflammatory markers, is a different proposition from splinting the airway — and, unlike SAVE, adherence is not the limiting factor.
Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med 2024 Oct 3;391(13):1193-1205.