The FDA has approved Zepbound, the first prescription drug specifically for treating moderate to severe obstructive sleep apnea (OSA) in adults with obesity. This approval marks a significant development in the management of OSA, a condition where the upper airway becomes blocked during sleep, leading to shallow or interrupted breathing. OSA can cause severe health issues, including heart rhythm disturbances, reduced oxygen levels, and overall health deterioration. Common symptoms include snoring, excessive daytime sleepiness, and disrupted sleep, but they often go unnoticed, especially in those with obesity.
Zepbound, a brand name for tirzepatide, is an injectable medication that works by promoting weight loss, a key factor in managing OSA in obese individuals. It does so by activating two specific receptors in the intestine glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) which help reduce appetite and decrease food intake. This dual-receptor activation makes Zepbound potentially more effective than drugs that target only the GLP-1 receptor, offering a promising approach for weight management and OSA treatment.
The drug’s approval follows results from two clinical trials involving 469 adults without type 2 diabetes. One trial included patients already using positive airway pressure (PAP), the standard treatment for OSA, while the other involved individuals not using PAP. In both studies, participants were randomly assigned to receive either Zepbound or a placebo weekly for 52 weeks. The findings revealed that Zepbound significantly reduced the number of breathing interruptions (apnea and hypopnea) during sleep compared to the placebo. Additionally, more patients treated with Zepbound experienced symptom improvement or resolution, along with notable weight loss, which likely contributed to the reduction in OSA symptoms.
Despite its benefits, Zepbound has some side effects, including nausea, vomiting, belching, acid reflux, stomach pain, diarrhea, constipation, tiredness, and injection site reactions. Some patients may also experience allergic reactions, hair loss, or other adverse effects. As with any medication, patients are advised to consult with their doctor before starting Zepbound, particularly if they have a history of thyroid cancer, serious allergies, or issues with their pancreas, gallbladder, kidneys, or eyes. Additionally, patients with a history of depression or suicidal thoughts should inform their healthcare provider, as Zepbound may have implications for mental health.
For those using insulin or other diabetes medications, doctors may need to adjust doses when starting Zepbound. Women who use birth control pills should also consult their doctor, as Zepbound may reduce the effectiveness of oral contraceptives. In such cases, an alternative form of birth control may be recommended for four weeks after starting Zepbound or following any increase in dosage.
In conclusion, Zepbound offers a new option for individuals with obesity and moderate to severe OSA, especially those who have not found adequate relief with traditional treatments. The combination of weight loss and improved airway function could significantly enhance the quality of life for many patients struggling with this sleep disorder. However, as with all medications, it is essential to monitor for side effects and consult with healthcare providers to ensure its safe and effective use.
