Tirzepatide Demonstrates Consistent Efficacy in OSA Across All Severity Levels, suggests research

A recent post-hoc analysis of the SURMOUNT-OSA trials revealed that tirzepatide significantly improves obstructive sleep apnea (OSA) symptoms and cardiometabolic parameters compared to placebo. These benefits were consistent regardless of patients' baseline OSA severity or use of positive airway pressure (PAP) therapy.

Tirzepatide improved indicators of OSA and cardiometabolic parameters, such as body weight (BW), systolic blood pressure (SBP), sleep apnea specific hypoxic burden (SASHB), apnea- hypopnea index (AHI), and C-reactive protein (CRP), in participants with moderate-to-severe OSA and obesity in the SURMOUNT-OSA clinical trials. Thus, to assess the relationships between tirzepatide therapy and changes in these indicators relative to a placebo by baseline OSA severity, Liao and colleagues carried out this investigation.

Over a 52-week period, two Phase 3 trials compared the effects of tirzepatide at its highest tolerated dose (10 mg or 15 mg once weekly) vs a placebo in persons with moderate-to-severe OSA and obesity. The participants in Study 2 were receiving positive airway pressure (PAP) treatment, whereas those in Study 1 were not.

The OSA severity categories were roughly similarly weighted by baseline AHI in these post-hoc analyses for on-treatment patients with non-missing baseline AHI measurements (moderate, AHI ≥15 to <30; severe, AHI ≥30 to <70; very severe, AHI ≥70). For binary outcomes, OSA-related measurements were examined using logistic regression; for continuous variables, mixed-model repeated measures were used.

The results revealed inconsistent relationships between baseline OSA severity and changes in cardiometabolic parameters or OSA measurements in both trials. Among Study 1 subjects not on PAP, there were significant differences across severity groupings for change difference in AHI and percent body weight decreases.

Across all severity categories, tirzepatide was linked to substantial decreases in AHI, SASHB, SBP, and BW when compared to placebo in Studies 1 and 2. In all trials, tirzepatide was substantially more likely than a placebo to reduce AHI by at least 50% across all severity categories. With the exception of the Study 1 extremely severe subgroup, tirzepatide significantly increased the probabilities of reaching an AHI of less than five or an AHI of five to fourteen with an Epworth Sleepiness Scale score of less than 10.

Although only the severe subgroup in both studies showed significant differences, tirzepatide was shown to reduce high-sensitivity CRP more than a placebo in all severity groups. Overall, tirzepatide was linked to substantial improvements in measures of OSA and cardiometabolic parameters in these post-hoc analyses of the SURMOUNT-OSA investigations.

Source:

Liao, B., Falcon, B., Bednarik, J., Xie, C., & Rapoport, D. M. (2025). Measures related to obstructive sleep apnea after tirzepatide treatment by baseline OSA severity: Post-hoc analyses of SURMOUNT-OSA. American Journal of Respiratory and Critical Care Medicine, 211(Abstracts), A5207–A5207. https://doi.org/10.1164/ajrccm.2025.211.abstracts.a5207