- Tirzepatide lead to a 63% mean reduction in restricted/obstructed breathing events per hour in patients with moderate to severe obstructive sleep apnea
- Tirzepatide lead to weight reduction and was well tolerated by study participants with mild adverse events.
The Latest
Two one-year long, double-blind, randomized phase 3 clinical trials funded by Eli Lilly and Company investigated the efficacy of Tirzepatide (10mg or 15mg) commercialized as Zepbound in the treatment of obstructive sleep apnea (OSA) in patients with moderate to severe OSA. The first study included OSA patients not on a continuous positive airway pressure machine (CPAP). While the second study included OSA patients on CPAP. Both studies demonstrated that tirzepatide showed a median reduction of up to 63% in the apnea-hypopnea index (AHI) – a measure of restricted/obstructed breathing events per hour. The first study demonstrated an average reduction of 27.4 events per hour while also reducing average weight by 18.1%. The second study demonstrated an average reduction of 30.4 events per hour while also leading to an average weight loss of 20.1%. Tirzepatide was well tolerated by patients and the common adverse events which include nausea, vomiting, and diarrhea were consistent with those reported in early phase clinical trials.
Physician’s Perspective
OSA is the most common sleep-related breathing disorder, especially among men. OSA occurs due to obstruction of the upper airway by collapse of muscles in the pharynx. This leads to restricted/obstructed breathing patterns during sleep which leads to reduced oxygen supply to the body. Symptoms of OSA include choking and gasping for air during sleep, poor sleep, and increased fatigue during the day. The first line treatment of OSA is PAP followed by weight loss and sleep hygiene. Untreated OSA can lead to high blood pressure, increased risk of stroke, heart disease and abnormal heart rhythms among others. The prognosis of untreated OSA is significantly worse than treated OSA as a result of the complications which lead to increased mortality. Eli Lilly’s evidence of Zepbound’s efficacy provides hope for an adjunct in the treatment of this disease.
Molecular Target of Therapy
Tirzepatide, brand name Zepbound, is a dual glucagon-like peptide 1 (GLP-1) receptor and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist. By activating these two receptors, tirzepatide leads to an increase in insulin secretion from the pancreas, reduced glucagon secretion, increased insulin sensitivity of cells, and reduced gastric emptying. The ultimate effect of this is reduced levels of blood sugar, increased fat breakdown, and reduced appetite.
Company History
Zepbound was developed by Eli Lilly and Company, a pharmaceutical company involved in the development of drugs for several diseases which include Alzheimer’s, pain, and cancer. Some examples include the biologic Donanemab, an antibody in phase 3 clinical trials for the treatment of Alzheimer’s disease. Another example is Mirkizumab, a drug under regulatory review, which has showed promising results in treating Crohn’s disease.
Further reading: https://lilly.mediaroom.com/2024-04-17-Tirzepatide-reduced-sleep-apnea-severity-by-up-to-nearly-two-thirds-in-adults-with-obstructive-sleep-apnea-OSA-and-obesity
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