LILLY'S TIRZEPATIDE REDUCED OBSTRUCTIVE SLEEP APNEA (OSA) SEVERITY, WITH UP TO 51.5% OF PARTICIPANTS MEETING THE CRITERIA FOR DISEASE RESOLUTION
- In the primary endpoint, tirzepatide reduced moderate-to-severe OSA severity by up to 62.8% (about 30 fewer events per hour)
- In a key secondary endpoint from two clinical studies, 43.0% and 51.5% of participants taking tirzepatide at the highest dose reached the criteria for disease resolution as defined by apnea-hypopnea index and Epworth Sleepiness Scale measures
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Lilly submitted tirzepatide for the treatment of moderate-to-severe OSA to the
U.S. Food and Drug Administration (FDA) and will initiate submissions for other global regulatory agencies in the coming weeks
In a key secondary endpoint, the efficacy estimand showed that 43.0% (Study 1) and 51.5% (Study 2) of participants treated with tirzepatide at the highest dose met the criteria for disease resolution. In this context, "disease resolution" means achieving an AHI of fewer than 5 events per hour, or an AHI of 5-14 events per hour and an Epworth Sleepiness Scale (ESS) score of ≤10. ESS is a standard questionnaire designed to assess excessive daytime sleepiness.1-4
OSA is a complex disease that can impact the progression of serious cardiometabolic complications, including hypertension, coronary heart disease, stroke, heart failure, atrial fibrillation and type 2 diabetes.5 Participants treated with tirzepatide in both studies experienced significant improvements in all key secondary endpoints including systolic blood pressure, hypoxic burden, and high-sensitivity C-reactive protein (hsCRP), an inflammation marker, compared to placebo.
"Obstructive sleep apnea is a very common, under recognized disease. When untreated, it can lead to many serious adverse health impacts." says Dr.
SURMOUNT-OSA Study 1 – Participants Not on PAP Therapy |
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|
Efficacy Estimand |
Treatment-Regimen Estimand
|
Primary Endpoint – Change in AHI from Baseline |
||
Tirzepatide* |
-27.4 |
-25.3 |
Placebo |
-4.8 |
-5.3 |
Secondary Endpoint – Percent Change in AHI from Baseline |
||
Tirzepatide* |
-55.0 % |
-50.7 % |
Placebo |
-5.0 % |
-3.0 % |
Secondary Endpoint – Percentage of Participants with AHI <5 or AHI 5-14 with ESS ≤10 |
||
Tirzepatide* |
43.0 % |
42.2 % |
Placebo |
14.9 % |
15.9 % |
Secondary Endpoint – Percentage of Participants with ≥50% AHI Reduction |
||
Tirzepatide* |
62.3 % |
61.2 % |
Placebo |
19.2 % |
19 % |
Secondary Endpoint – Percent Change in Body Weight |
||
Tirzepatide* |
-18.1 % |
-17.7 % |
Placebo |
-1.3 % |
-1.6 % |
SURMOUNT-OSA Study 2 Participants Used PAP Therapy |
||
|
Efficacy Estimand |
Treatment-Regimen Estimand |
Primary Endpoint –Change in AHI from Baseline |
||
Tirzepatide* |
-30.4 |
-29.3 |
Placebo |
-6.0 |
-5.5 |
Secondary Endpoint – Percent Change in AHI from Baseline |
||
Tirzepatide* |
-62.8 % |
-58.7 % |
Placebo |
-6.4 % |
-2.5 % |
Secondary Endpoint – Percentage of Participants with AHI <5 or AHI 5-14 with ESS ≤10 |
||
Tirzepatide* |
51.5 % |
50.2 % |
Placebo |
13.6 % |
14.3 % |
Secondary Endpoint – Percentage of Participants with ≥50% AHI Reduction |
||
Tirzepatide* |
74.3 % |
72.4 % |
Placebo |
22.9 % |
23.3 % |
Secondary Endpoint – Percent Change in Body Weight |
||
Tirzepatide* |
-20.1 % |
-19.6 % |
Placebo |
-2.3 % |
-2.3 % |
*For both SURMOUNT-OSA study 1 and study 2, Tirzepatide MTD is maximum tolerated dose of 10 mg or 15 mg once-weekly. The starting dose of 2.5 mg tirzepatide was increased by 2.5 mg every four weeks until maximum tolerated dose was achieved. Participants who tolerated 15 mg continued on 15 mg as their maximum tolerated dose. Participants who tolerated 10 mg but did not tolerate 15 mg continued on 10 mg as their maximum tolerated dose.
"One in five Canadians are impacted by obstructive sleep apnea (OSA) and this complex disease is linked to very serious health complications," says Dr.
The overall safety profile of tirzepatide in SURMOUNT-OSA studies was similar to previously reported SURMOUNT and SURPASS trials. The most commonly reported adverse events in SURMOUNT-OSA were gastrointestinal related and generally mild to moderate in severity. The most frequent events reported by those on tirzepatide compared with placebo, respectively, were diarrhea (26.3% vs 12.5%), nausea (25.4% vs 10.0%) and vomiting (17.5% vs 4.2%) in SURMOUNT-OSA Study 1, and diarrhea (21.8% vs 8.8%), nausea (21.8% vs 5.3%) and constipation (15.1% vs 4.4%) in SURMOUNT-OSA Study 2. Adverse events led to discontinuation of study treatment in 9 participants taking tirzepatide (5 in Study 1 and 4 in Study 2) and 10 taking placebo (2 in Study 1 and 8 in Study 2).
Tirzepatide is the only approved GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) treatment for chronic weight management, commercialized as Zepbound® in the
SURMOUNT-OSA (NCT05412004) was a multi-centre, randomized, double-blind, parallel, placebo-master protocol comparing the efficacy and safety of tirzepatide to placebo in adults living with moderate-to-severe obstructive sleep apnea and obesity who were unable or unwilling to use positive airway pressure (PAP) therapy (Study 1) and those who were and planned to stay on PAP therapy during the duration of the trial (Study 2). Under a master protocol, the trials randomized 469 participants across the U.S., Australia, Brazil, China, Czechia, Germany, Japan,
SURMOUNT-OSA utilized a MTD of 10 mg or 15 mg once-weekly. The starting dose of 2.5 mg tirzepatide was increased by 2.5 mg every four weeks until maximum tolerated dose was achieved. Participants who tolerated 15 mg continued on 15 mg as their MTD. Participants who tolerated 10 mg but did not tolerate 15 mg continued on 10 mg as their MTD.
Tirzepatide is approved in
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References |
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