Zepbound (tirzepatide), the first drug approved by the U.S. Food and Drug Administration (FDA), is used to treat moderate to severe obstructive sleep apnoea (OSA) in obese people. To be taken in conjunction with a diet lower in calories and more exercise.

Recurrent episodes of partial or total obstruction of the upper airway during sleep are the hallmark of obstructive sleep apnoea (OSA), a common sleep disease. These blockages create breathing problems, which can lead to sleep disturbances and a drop in blood oxygen levels. As the person strains to breathe, OSA is frequently accompanied by loud snoring, gasping, or choking sounds. Usually identified by a polysomnography (sleep study), which records oxygen levels, breathing patterns, and other physiological factors while the patient is asleep.

The goals of traditional therapies for obstructive sleep apnoea (OSA) are to improve breathing while you sleep, lessen airway obstruction, and improve your general health. These are the main strategies: lifestyle changes including quitting smoking, avoiding alcohol and sedatives, posture therapy, and losing weight. Continuous Positive Airway Pressure (CPAP) is another option. Although there is currently no first-line pharmacological treatment for OSA, certain drugs (such as those for fluid retention or nasal congestion) may be used as adjuncts.

Zepbound (tirzepatide) is authorized for the long-term control of weight and diabetes. Tirzepatide is a dual agonist that acts on two important receptors that control metabolism: Glucose-Dependent Insulinotropic Polypeptide (GIP) Receptor: This receptor may help control appetite by increasing insulin production in response to meal intake. Stimulation of the glucagon-like peptide-1 (GLP-1) receptor aids in controlling calorie intake and appetite.

Zepbound approval has made it the first medication treatment choice for some obstructive sleep apnoea patients.

Two randomized, double-blind, placebo-controlled trials including 469 individuals without type 2 diabetes served as the foundation for Zepbound approval for moderate to severe OSA in obese adults. One trial included patients who were unable or unwilling to employ positive airway pressure (PAP), the gold standard for treating moderate to severe OSA. For 52 weeks, individuals in both trials were randomly assigned to take either 10 or 15 mg of Zepbound or a placebo once a week. At week 52, the main indicator of effectiveness was the change from baseline in the apnoea hypopnoea index (AHI), which counts the number of times a person stops breathing (apnoea) or breaths shallowly (hypopnoea) per hour while they are asleep. In both studies, after 52 weeks of treatment, participants who received Zepbound had a statistically significant and clinically meaningful decrease in apnoea or hypopnoea events as determined by AHI when compared to those who received a placebo. Additionally, a higher percentage of participants treated with Zepbound experienced mild OSA or remission with resolution of symptoms than those treated with a placebo. Participants’ body weight significantly decreased after receiving Zepbound treatment at 52-week comparison with a placebo. Participants with OSA who used Zepbound to reduce their body weight probably saw an improvement in their AHI.

FDA recommends that Zepbound should be used in conjunction with a lower-calorie diet and more exercise. Even if Zepbound provides a novel therapeutic option, not all OSA patients, especially those with structural airway problems, may benefit from it. The American Academy of Sleep Medicine stresses that in order for the drug to effectively treat the symptoms of sleep apnoea, weight loss must persist. With its approval, OSA treatment has advanced significantly and patients, particularly those who have trouble with current medications, now have a pharmaceutical choice.

Zepbound received designations from the FDA for OSA on Fast Track, Priority Review, and Breakthrough Therapy under Eli Lilly and Co.