Journal club

Abstract

There are no licensed pharmacological treatments for obstructive sleep apnoea (OSA). Obesity is a modifiable risk factor for OSA with existing pharmacological interventions. One such treatment is tirzepatide which is a long-acting glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and glucagon-like peptide-1 (GLP-1) receptor agonist. Malhotra et al . (N Engl J Med 2024;391:1193–1205) reported the SURMONT-OSA phase three trials which evaluated the safety and efficacy of tirzepatide for the treatment of OSA in obese adults. SURMONT-OSA comprised of two multi-centre, international, double-blind, randomised, controlled trials conducted over 52 weeks. All participants had moderate-severe OSA. Participants were randomised to placebo or tirzepatide treatment arms. Trial one included participants unable or unwilling to use positive airway pressure (PAP) therapy (n=234) and trial two included participants using and continuing PAP therapy (n=235). The primary end-point was the change in apnoea-hypopnea index (AHI) from baseline. In trial one the mean change in AHI at week 52 was −25.3 events/hour (95% CI, −29.3 to −21.2) with tirzepatide and −5.3 events/hour (95% CI, −9.4 to −1.1) with placebo. In trial 2, after withdrawing PAP therapy, the mean change in AHI at week 52 with tirzepatide was −29.3 events/hour (95% CI, −33.2 to −25.4, p<0.001) and …