Experimental Weight-Loss Drug Shows Promise for Treating Sleep Apnea

An experimental weight-loss drug, retatrutide, has demonstrated significant success in reducing symptoms of obstructive sleep apnea (OSA) in adults who are overweight or obese, according to new research published in The New England Journal of Medicine.

Obstructive sleep apnea affects an estimated 50 million Americans, with a large percentage of cases going undiagnosed, according to the National Sleep Foundation. The investigational drug, developed by Eli Lilly, was evaluated in two Phase 3 clinical trials to assess its potential as a treatment for OSA.

Study Details

The randomized trials involved 691 adults with moderate-to-severe sleep apnea and a body mass index (BMI) of at least 27. Participants received weekly injections of retatrutide at doses of 4, 9, or 12 milligrams, or a placebo, over an 80-week period. The study included individuals both with and without type 2 diabetes.

Results indicated that participants receiving retatrutide experienced substantial weight loss, ranging from 12% to nearly 20% of their body weight. Crucially, they also showed significantly fewer breathing interruptions, as measured by the apnea-hypopnea index (AHI), compared to those who received a placebo. Approximately 68% of participants experienced more than a 50% improvement in OSA symptoms, irrespective of their diabetes status.

The research also highlighted a marked reduction in hypoxic burden, the severity and duration of low-oxygen episodes during sleep. This burden decreased by about 75% in participants without type 2 diabetes and 65% in those with the condition. The study concluded that retatrutide led to greater reductions in AHI than placebo in overweight and obese adults with OSA.

Cardiovascular and Metabolic Benefits

Beyond its impact on sleep apnea, retatrutide also showed positive effects on cardiovascular risk factors and metabolic health. Participants experienced reductions in systolic blood pressure, LDL cholesterol, systemic inflammation, and neck circumference. In individuals without diabetes, insulin levels decreased by over 50%. Among those with type 2 diabetes, a notable percentage saw improvements in their condition, with 40% progressing from diabetes to prediabetes and another 40% no longer meeting the criteria for diabetes.

Dr. Virend V. Somers, a cardiologist and professor of medicine at Mayo Clinic who co-authored the study, expressed optimism about the findings. He noted the significant benefits observed, particularly in patients with type 2 diabetes, and the considerable reduction in sleep apnea severity. Somers indicated that the improvements in these cardiovascular risk factors are predictive of reduced future cardiovascular risk.

Expert Reaction and Future Outlook

While retatrutide is not yet approved by the FDA, these findings suggest a potential new therapeutic avenue for OSA. Dr. Wendy Troxel, a senior behavioral scientist at RAND, who was not involved in the study, commented that OSA is frequently under-diagnosed and under-treated. She expressed hope that increased awareness of treatment options like retatrutide could encourage more individuals to seek screening and care.

The researchers emphasized that these results do not suggest patients should discontinue existing treatments such as CPAP machines. Further research is necessary to fully understand the long-term safety and efficacy of retatrutide for sleep apnea. However, the study indicates a promising future with the potential for drug therapies to complement or, in some cases, reduce the need for traditional treatments for sleep apnea.