Mounjaro Improved Obstructive Sleep Apnea Outcomes

For people with moderate-to-severe obstructive sleep apnea (OSA) and obesity, treatment with Mounjaro (tirzepatide; Lilly, Indianapolis, IN) was associated with reduced apnea-hypopnea index (AHI), body weight, hypoxic burden, high-sensitivity C-reactive protein (hsCRP) concentration, and systolic blood pressure, as well as improved sleep-related patient-reported outcomes. Results of the SURMONT-OSA study (NCT05412004) were published in The New England Journal of Medicine.

SURMOUNT-OSA, consisting of 2 phase 3, double-blind, randomized controlled trials, enrolled a total of 469 participants with moderate-to-severe OSA and obesity. Participants who did not use positive airway pressure (PAP) within 4 weeks prior to screening were included in the first trial, while those who used PAP for ≥3 consecutive months before screening were included in the second trial. In both trials, participants were randomized 1:1 to receive subcutaneous injections of placebo or Mounjaro at a maximum tolerated dose of 10 mg or 15 mg for 52 weeks. The primary endpoint was change from baseline in AHI, which measures the number of apneas and hypopneas during an hour of sleep.

Results from the first trial:

• For participants treated with Mounjaro, there was a mean change in AHI of 25.3 events per hour at week 52 (95% CI, -29.3 to -21.2).
• For those receiving placebo, the mean change in AHI was 5.3 events per hour (95% CI, -9.4 to -1.1).
• The estimated treatment difference was 20.0 events per hour (95% CI, -25.8 to -14.2; P<.001)

In the second trial:

• For participants treated with Mounjaro, there was a mean change in AHI of 29.3 events per hour at week 52 (95% CI, -33.2 to -25.4).
• For those receiving placebo, the mean change in AHI was 5.5 events per hour (95% CI, -9.9. to -1.2).
• The estimated treatment difference was 23.8 events per hour (95% CI, -29.6 to -17.9; P<.001)

Mounjaro is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist approved as a subcutaneous injection for the treatment of adults with type 2 diabetes mellitus (T2DM) as an adjunct to diet and exercise to improve glycemic control. The medication’s label contains a Boxed Warning for risk of thyroid C-cell tumors. The SURMOUNT-OSA study was conducted with funding from Eli Lilly and Company (Indianapolis, IN).