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Discussants

Clete Kushida (United States)
Patrick Strollo (United States)
Christine Won (United States)
Danny Eckert (Australia)
Ingo Fietze (Germany)
Najib Ayas (Canada)

BACKGROUND:

The primary treatments for obstructive sleep apnea (OSA) are currently positive airway pressure, oral appliances, and upper airway surgery. However, the results of the SURMOUNT-OSA controlled trial evaluating the safety and efficacy of tirzepatide, i.e., a glucagon-like peptide-1 (GLP-1) receptor agonist and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, in treating moderate-to-severe OSA patients who were also obese, showed that tirzepatide significantly reduced OSA severity, body weight, hypoxic burden, and other relevant measures in these patients. Subsequently, in December 2024, the FDA approved tirzepatide as the first prescription medication for adult patients with moderate-to-severe OSA and obesity. The participants in this discussion group will consider and discuss practical approaches in the use of tirzepatide (and other similar medications in the pipeline) for the management of their patients with OSA and obesity.

SIGNIFICANCE:

Pharmacologic OSA treatment is a new and emerging field of sleep medicine with studies on novel compounds such as atomoxetine and oxybutynin, and, with the FDA approval of tirzepatide, patients are asking their physicians, including sleep medicine specialists, if this medication can successfully treat their OSA and obesity. This discussion group will describe the experience of international sleep medicine experts in managing clinical and research patients with tirzepatide and similar medications by focusing on the key questions indicated below.

NOVELTY:

Tirzepatide and similar medications offer the delivery of greater patient-centered care in OSA treatrment. We will discuss the opportunities and challenges of incorporating these medications in the management of OSA patients now and in the future.

KEY QUESTIONS TO BE DISCUSSED:

- What is your experience with tirzepatide/similar medications in the clinical and/or research setting?
- What do you take away from the research studies on the mechanisms, efficacy, and safety of these medications?
- What do you tell your patients regarding indications, adverse effects, and drug interactions of these medications?
- Who do you think is the most appropriate health care provider to prescribe these medications (e.g., sleep medicine specialists, primary care physicians, bariatric/weight loss physicians, advance practice providers) and to manage the long-term follow-up of these patients?
- How do you think these medications best fit within the current OSA treatment options?
- What do you think is the optimal clinical workflow for managing patients with these medications?
- What are your predictions for the future in the overall management of OSA patients and what research is lacking and should be explored?

Learning Objectives:

Upon completion of this CME activity, participants will be able to:
• Describe tirzepatide/similar medications and their actions on OSA and obesity
• Consider who will prescribe these medications and how patients will be managed/followed over time
• Discuss the future of how these medications will fit within clinical workflows and what future research is needed
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