GLP-1 RAs Reduce OSA Severity in Patients Without Diabetes

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with a significant decrease in apnea-hypopnea index (AHI) among patients with moderate to severe obstructive sleep apnea (OSA) and without diabetes, although they may lead to an increased risk of gastrointestinal side effects, according to study findings published in Sleep Medicine.

Researchers conducted a systematic review and meta-analysis to evaluate the efficacy and safety of GLP-1 RAs in individuals with OSA and elevated body weight who do not have diabetes. The meta-analysis included randomized controlled trials (RCTs) reporting on the effect of GLP-1 RAs on OSA severity and overall adverse events.

A literature search was performed for studies published from inception to September 11, 2024, in the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Scopus databases. The trials enrolled adults aged at least 18 years with moderate to severe OSA and a body mass index (BMI) of 30 kg/m² or greater. The primary outcomes were changes in AHI and overall adverse events.

The review and meta-analysis included 3 RCTs from 2 studies. Participants had an average age of 47.3 to 52.7 years, a baseline AHI of 46.1 to 53.1 events per hour, and a BMI of 38.6 to 39.7 kg/m². Patients in the GLP-1 RA groups received subcutaneous liraglutide or tirzepatide in escalating doses, with liraglutide at doses of as much as 3.0 mg/day and tirzepatide in doses of up to 10 to 15 mg weekly for 32 to 52 weeks.

In the pooled analysis, a significant decrease in AHI was observed with GLP-1 RA treatment compared with placebo. The weighted mean difference in AHI was −8.00 events per hour (95% CI, −13.57 to −2.43), which demonstrated a statistically significant improvement in OSA severity for GLP-1 RA treatment.

The odds ratio for adverse events in the GLP-1 RA group compared with the placebo group was 1.62 (95% CI, 1.16-2.24), which indicated a significantly increased frequency of events in the GLP-1 RA group vs the placebo group.

Limitations include the small number of studies and follow-up periods of up to 52 weeks. In addition, AHI reduction does not fully encompass treatment efficacy.

“GLP-1 RAs effectively reduce OSA severity, offering a promising alternative for individuals with OSA and elevated body weight. However, the increased risk of side effects must be considered,” the study authors concluded.

This article originally appeared on Pulmonology Advisor