Dr. Ahmed If you have been struggling with sleep apnea, then there is some good news for you. The U.S. Food and Drug Administration has said yes to Zepbound (Tirzepatide) for the treatment of moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity.
This revelation is rather important for those who struggle with OSA on a daily basis, considering how common that condition is.
Understanding Obstructive Sleep Apnea
This is a condition marked by repeated episodes of upper airway obstruction during sleep, leading to intermittent reductions in blood oxygen levels and frequent awakenings. This problem in sleep patterns can result in:
- excessive daytime sleepiness,
- fatigue,
- difficulty concentrating,
- and an increased risk of cardiovascular problems, among some other health issues.
Obesity is a prominent risk factor for obstructive sleep apnea, with excess weight contributing to the narrowing of the upper airway.
While lifestyle interventions like weight loss and continuous positive airway pressure (CPAP) therapy are considered first-line treatments, sticking to these methods can be a bit challenging for many individuals.
Wonders of Zepbound for OSA
Zepbound, developed by Eli Lilly, is a once-weekly injectable medication that has already been approved for the therapy of type 2 diabetes and obesity.
Its active ingredient, tirzepatide, works by mimicking the effects of two naturally occurring hormones in the body: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones perform a vital role in regulating blood sugar levels, appetite, and energy balance.
By targeting these hormonal pathways, Zepbound has demonstrated prominent effects in promoting weight loss. Furthermore, this loss of weight has been shown to significantly improve OSA outcomes.
There is clinical evidence, too!
The clinical trials leading to Zepbound’s approval showed the med’s ability to substantially lower the number of sleep disturbances per hour, which is a key measure of OSA severity.
Subjects treated with Zepbound had a notable decrease in their apnea-hypopnea index (AHI), a metric used to assess the frequency of breathing pauses and shallow breaths during sleep.
The recent approval for OSA treatment comes from the results of two Phase 3 trials called SURMOUNT-OSA. These were double-blind, randomized controlled studies done at 60 locations in nine countries.
They looked at how tirzepatide affects people with obesity and moderate to severe OSA. The findings were shared in June 2024 at the American Diabetes Association’s annual conference and published online at the same time in The New England Journal of Medicine.
The trials included a total of 703 participants. So, the first study involved 469 individuals who were not willing or unable to use PAP therapy, while the second included 234 participants who had been using PAP therapy for at least three months and intended to continue.
Both groups were randomized to receive weekly doses of either 10 milligrams or 15 mg of tirzepatide or a placebo over a 52-week period.
Moreover, 65%-70% of participants had severe OSA, with an average of 51.5 events per hour on the apnea-hypopnea index (AHI).
Surprisingly, after 52 weeks, those treated with tirzepatide experienced a reduction of 27-30 events per hour, compared to a decrease of only 4-6 events per hour in the placebo group.
Additionally, a significantly higher proportion of tirzepatide recipients achieved remission or a reduction in OSA severity to mild levels.
Lastly, participants on tirzepatide also achieved up to 20% weight loss on average, far exceeding outcomes observed with a placebo.
According to the FDA, this weight reduction likely contributed to the substantial improvements in AHI observed in participants treated with Zepbound.
A new treatment option
The FDA’s approval of Zepbound marks a big step forward in treating obstructive sleep apnea (OSA) [ref].
For the first time, doctors have a medication that tackles the main cause of OSA in people with obesity. This new option could bring many important benefits to patients.
- Zepbound is better than CPAP because the latter needs people to consistently use a mask and airflow device while the former is only injected once a week. So, this is less burdensome and it leads to improved treatment adherence and long-term outcomes.
- This drug is paying attention to the main cause behind sleep apnea and that is obesity. It is like killing two birds with one stone as users lose weight while fixing their sleep patterns.
- It can be used in combination with other OSA treatments, such as CPAP or Oral appliances, which raises the chances of a positive outcome.
Looking ahead
While Zepbound gives a promising new route for OSA treatment, it is better to recognize that it is not a one-size-fits-all solution.
The medication is importantly indicated for adults with moderate-to-severe OSA and obesity, and its use should be guided by a healthcare professional.
Furthermore, this drug is not meant to replace any sort of health habits like weight loss, staying physically active, or improving sleep routine.
The approval of Zepbound is so important in the fight against obstructive sleep apnea (OSA). It gives new hope for many of those individuals who are struggling with this debilitating condition, offering a potential pathway to improved sleep quality, enhanced well-being, and a much lower risk of long-term health complications.
As research continues and clinical experience with Zepbound grows, we can anticipate further refinements in its use and a brighter future for OSA management.
