Explained: How US Obesity Drug May Help Treat Sleep Apnea; India Will Have To Wait

Tirzepatide, a drug used to treat diabetes and obesity, may help reduce sleep apnea and can completely resolve the disorder, according to a study published in the New England Journal of Medicine. Sleep apnea is a dangerous disorder, making people struggle to breathe during their sleep. In India, at least one million persons are diagnosed with sleep apnea every year.

Hyderabad:Do you suffer from sleep apnea? If yes, you should read on. A US drug manufacturer says they have a shot at curing the dangerous disorder through their wonder drug, meant for obesity and diabetes control. A recent study published in the New England Journal of Medicine, sponsored by the drug manufacturer suggests that it may help treat the disorder.

According to an expert, more research will be needed to tell if the drug can be used as "a sole treatment" for obstructive sleep apnea, which occurs when tissue in the throat relaxes and collapses during sleep, fully or partially blocking the airway.

'Sleep Apnea'

It is a dangerous condition wherein people struggle to breathe when they sleep. The disorder makes those affected stop and start breathing during their sleep. According tothe Ministry of Health and Family Welfare, it is a serious sleep disorder, which is expected to worsen with risk factors including age and obesity. History shows the disorder is reported more commonly among men. In India, the incidence rate is more than 10 lakh cases are reported every year.

Loud snoring at sleep and having a tired feeling even after a full night's sleep are the major symptoms of sleep apnea. It can cause brain fog and daytime sleepiness but also severe long-term issues such as heart disease, dementia and early death.

At present, changes in lifestyle including weight loss and the use of a breathing assistance device, such as a continuous positive airway pressure (CPAP) machine, at night as part of the treatment regimen. The disorder can last for years or be lifelong.

What Research Said

Tirzepatide is used in the medication in Eli Lilly and Co's weight-loss drug Zepbound and in the diabetes treatment Mounjaro. The study showed the medicine helped the patients with sleep apnea by reducing the severity of it, besides helping them to reduce weight and improve blood pressure and other health measures. The study was carried out on patients with obesity who had been taking the drug for a year.

Eli Lilly and Co who sponsored the research has applied to the Food and Drug Administration (FDA) to allow the use of the drug in the treatment of moderate to severe sleep apnea. The FDA is likely to decide on the application by the end of the year, AP reported.

The Study's Findings

The research studied 500 people diagnosed with obesity and sleep apnea. While half of them used a CPAP machine, which feeds oxygen through a mask to keep airways open during sleep, the rest had people for whom a CPAP machine had failed or wasn't tolerated.

The patients from both groups received weekly tirzepatide injections. The drug halved the episodes of breath slowing down or stopping completely . The hourly analysis showed the efficacy rate went up to 60%. The same was at about 10% in the group which received the placebo. The study showed nearly half of the patients taking tirzepatide had reduced sleep apnea episodes and it was to the extent to which it may resolve the disorder. Also, the same was experienced at 16% in those who received a placebo, the study showed.

On average, patients who took tirzepatide also lost between 18% and 20% of their body weight and showed improvements in blood pressure and a condition in which blood oxygen drops during sleep. Patients also reported better sleep and fewer sleep disturbances, AP reported citing the study.

The new research shows that tirzepatide is "a more effective knife in the drawer," for treating sleep apnea, the report quoted the lead author Dr. Atul Malhotra, a sleep medicine specialist at the University of California, San Diego, as saying.

Pitfalls

The study had an accompanying editorial by Dr. Sanjay Patel. He is a sleep medicine specialist at the University of Pittsburgh. He cautioned that whether tirzepatide can treat sleep apnea in real-world patients "remains unclear" citing the way improvement was measured in the study. Patel said the cost and access would become obstacles to tirzepatide use. He added that adding the drug as a treatment could further exacerbate racial and other disparities in addressing sleep apnea.

Promising

According to Dr. Paul Peppard, a sleep medicine researcher at the University of Wisconsin, losing weight has long been recommended as a way to reduce the severity of sleep apnea. He said weight loss would mean, expansion of lung capacity and reduction of fat in the airways and improvement in oxygen use. While diet and exercise can speed up weight loss and reduce the consequences of the disorder, the doctor said many in the US find it difficult to do it amid the ongoing obesity epidemic. He said medications such as tirzepatide can help in such cases.

"I expect that these drugs could be used as a tool to treat many of the established outcomes of obesity," AP quoted Peppard, who was not involved in the study, as saying.

India Will Have To Wait

In India, the drug is yet to be marketed. Cipla and Lupin Pharma are two Indian drug companies which have tie-ups with Eli Lilly. Cipla has rights to sell, promote and distribute Eli Lilly’s two insulins in India.

The company has an existing partnership with American company Eli Lilly, with whom it is culturally aligned, The Hindu BL quoted Umang Vohra, Cipla Managing Director and Global Chief Executive Officer as saying, adding that the company was “always open to a partnership” to bring in its diabetes product that has since gained popularity in the obesity and weight-loss segments, as well.

While the popularity of tirzepatide has resulted in global supply pressure on the products, Eli Lilly's CEO David Ricks, earlier this year, said the company was expecting to launch Mounjaro, in India by 2025 and is awaiting the nod of Central Drugs Standard Control Organization(CDSO).

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