An experimental obesity medication has shown promising results in reducing breathing interruptions and other symptoms associated with obstructive sleep apnea (OSA) across two clinical trials, as reported in a recent study published in The New England Journal of Medicine.
According to the National Sleep Foundation, OSA affects over 50 million people in the United States, with around 80% of cases remaining undiagnosed.
The focus of the study was on retatrutide, a weight-loss drug being investigated by Eli Lilly, to see its effectiveness in treating OSA in overweight or obese adults.
Study Overview
The trials included 691 adults suffering from moderate to severe sleep apnea who had a body mass index (BMI) of at least 27. Participants received weekly injections of retatrutide in varying doses (4, 9, or 12 mg) or a placebo, and they were monitored for an 80-week period.
Out of the participants, 243 did not have type 2 diabetes, while 448 did. Those administered retatrutide experienced weight loss of between 12% and nearly 20% and saw a notable decrease in breathing interruptions compared to those who received a placebo.
Remarkably, around 68% of participants reported over a 50% improvement in OSA symptoms, regardless of their diabetes status.
The study also highlighted a significant reduction in the severity and duration of low-oxygen episodes among participants, which dropped by approximately 75% in those without type 2 diabetes and 65% in those with the condition.
Overall, researchers found that retatrutide produced more substantial reductions in the apnea-hypopnea index (AHI), which measures breathing interruptions, compared to the placebo among obese or overweight adults with OSA.
Expert Insights
Dr. Virend Somers, a cardiologist and co-author of the study from Mayo Clinic, expressed that while he expected positive results, the extent of the benefits especially for patients with type 2 diabetes was surprising. He described the current period in treating sleep apnea as very promising.
The link between sleep apnea and increased risks for heart disease, strokes, and high blood pressure was also emphasized, with participants demonstrating improved cardiovascular risk factors such as reduced blood pressure and LDL cholesterol levels during the trial.
Somers pointed out that improvements in these health markers could indicate a lowered cardiovascular risk and that retatrutide also positively impacted diabetes-related measures, with notable decreases in insulin levels among participants.
In fact, 40% of participants with type 2 diabetes transitioned from diabetes to prediabetes, and another 40% no longer met diabetes criteria.
Participants generally reported better sleep beyond just the direct effects of the sleep apnea. Interestingly, usage of CPAP devices, commonly prescribed for sleep apnea, seemed to decrease throughout the study, suggesting there may be a potential for patients to rely less on such devices in the future.
Dr. Wendy Troxel from RAND, who was not part of the study, remarked on the issue of under-diagnosis and treatment of OSA, particularly in postmenopausal women. She expressed hope that increased awareness of treatments could prompt more individuals to seek screening and treatment.
Notably, about 25% of non-diabetic participants and 15% of those with type 2 diabetes saw their condition resolve entirely. However, researchers cautioned that these findings do not imply that patients should discontinue CPAP use or other prescribed therapies, underscoring the need for further research to establish the long-term safety and efficacy of retatrutide for treating sleep apnea.
In closing, Somers conveyed optimism for the future of sleep apnea treatment, noting the combined options available now for managing the condition, including the potential benefits of new drug therapies.
