On December 20, 2024, the FDA approved Zepbound® (tirzepatide) for the treatment of moderate to severe obstructive sleep apnea (OSA) in adults with obesity, to be used in combination with a reduced-calorie diet and increased physical activity. OSA is a disorder in which a person’s upper airway becomes blocked during sleep, causing pauses in breathing. It is more common in people who are overweight or obese. Zepbound® works by activating receptor of hormones secreted within the intestine to reduce appetite and food intake, leading to improvements in OSA symptoms by reducing body weight.
The approval for Zepbound® in OSA was based on two randomized, double-blind and placebo-controlled studies of 469 adults without type 2 diabetes. In one study, participants enrolled were using positive airway pressure (PAP), the standard care for moderate to severe OSA. The other study enrolled participants unable or unwilling to use PAP. In both studies, participants randomly received either 10 or 15 milligrams of Zepbound® or placebo once weekly for 52 weeks. After 52 weeks of treatment, participants who received Zepbound® experienced a clinically meaningful reduction in events of apnea and significant decrease in body weight compared with those receiving placebo. With this, it is likely that the benefit for OSA is associated with the reduction in body weight for members who were in the treatment group.