tirzepatide · 112 weeks
SURMOUNT-MAINTAIN
At week 112, weight had changed by −21.9% on the maximum tolerated dose of tirzepatide, −16.6% on 5 mg and −9.9% on placebo.
Randomized controlled trial
SURMOUNT-OSA: tirzepatide (Zepbound) for sleep apnea and obesity
At 52 weeks, the AHI fell by 25.3 events per hour with tirzepatide and 5.3 with placebo in trial 1 (difference of −20.0; 95% CI, −25.8 to −14.2), and by 29.3 versus 5.5 in trial 2 (difference of −23.8; 95% CI, −29.6 to −17.9).
Malhotra A et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. New England Journal of Medicine, 2024. DOI: 10.1056/NEJMoa2404881
- Prepared by
- Alex Gonzalez
- Last updated
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Key facts
- Drug
- tirzepatide
- Design
- Randomized controlled trial
- Participants
- 469
- Duration
- 52 weeks
- Funding
- Eli Lilly
- Registry
- NCT05412004
- Population
- 469 adults with moderate or severe obstructive sleep apnea and obesity (BMI of 30 or more; 27 or more in Japan), without diabetes, in two parallel trials: trial 1 with 234 people who were not using positive airway pressure (PAP, such as CPAP) and trial 2 with 235 who were. Mean baseline apnea-hypopnea index was 51.5 and 49.5 events per hour, and mean BMI was 39.1 and 38.7.
- Primary outcome
- Change in the apnea-hypopnea index (AHI, the number of apneas and hypopneas per hour of sleep) from baseline to week 52 with the maximum tolerated dose of tirzepatide (10 or 15 mg once weekly) versus placebo.
What it found
At 52 weeks, the AHI fell by 25.3 events per hour with tirzepatide and 5.3 with placebo in trial 1 (difference of −20.0; 95% CI, −25.8 to −14.2), and by 29.3 versus 5.5 in trial 2 (difference of −23.8; 95% CI, −29.6 to −17.9). Weight changed by −17.7% versus −1.6% in trial 1 (difference of −16.1 percentage points; 95% CI, −18.0 to −14.2) and by −19.6% versus −2.3% in trial 2 (difference of −17.3 points; 95% CI, −19.3 to −15.3). Hypoxic burden, C-reactive protein, systolic blood pressure and participant-reported sleep impairment also improved versus placebo. The most common adverse effects with tirzepatide were digestive, mostly mild or moderate.
Limitations
Funded by Eli Lilly; the statistical analyses were done by employees of the sponsor. At 52 weeks, it cannot assess long-term cardiovascular outcomes. It only included people with obesity and without diabetes. Trial 2 was not designed to find out whether the drug changes CPAP use. The trial was completed by 91.5% of participants on tirzepatide and 74.4% on placebo.
What it means for you
In people with obesity and moderate or severe obstructive sleep apnea, tirzepatide (Zepbound) reduced apneas and hypopneas by an average of 25 to 29 per hour of sleep, compared with about 5 on placebo. The trial did not assess whether it allows people to stop using CPAP. If you have sleep apnea, any change to its treatment should be discussed with your doctor or sleep clinic.
Further reading
- How Much Weight Do People Lose on Ozempic, Wegovy or Zepbound? Trial Data
- Ozempic vs Mounjaro (and Zepbound): Real Differences From the Trials and Labels
- What Happens When You Stop Ozempic, Wegovy or Zepbound: Weight Regain, Explained
- GLP-1 drug pages
- All study summaries
- Original paper: doi.org/10.1056/NEJMoa2404881
Sources
The original paper and the records consulted for this summary, with the date they were accessed.
- New England Journal of Medicine.Malhotra A, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med. 2024;391(13):1193-1205.accessed .
- National Library of Medicine (PubMed).PubMed record PMID 38912654 (abstract).accessed .
- PubMed Central (National Library of Medicine).Full text PMC11598664 (author manuscript: participants, weight results, limitations, funding).accessed .