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Liraglutide reduces sleep apnea severity in adults with obesity
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Adults with obesity and moderate to severe obstructive sleep apnea assigned once weekly liraglutide saw significant reductions in apnea-hypopnea index measurements, body weight, systolic blood pressure and HbA1c over 32 weeks, according to recent study findings.
In a randomized double blind , parallel-group trial, Adam Blackman MD, FRCPC, DABSM, DABPN, president and chief medical director of MedSleep in Toronto, and colleagues analyzed data from 276 adults without diabetes and BMI at least 30 kg/m² who had moderate to severe sleep apnea (AHI between 15 and 29.9 events per hour) and were unwilling to use continuous positive airway pressure (CPAP) therapy (mean age, 49 years; 71.9% men; mean AHI, 49.2 events per hour; 67.1% with severe OSA; mean BMI, 39.1 kg/m²; mean HbA1c, 5.7%). Researchers randomly assigned participants to 3 mg subcutaneous liraglutide (n = 134) or placebo (n = 142) for 32 weeks; all participants received counseling on diet (500 kcal per day deficit) and physical activity (at least 150 minutes per week advised), filled out 3-day food diaries every 5 to 8 weeks and were given pedometers. Primary endpoint was change in AHI from baseline to week 32.
Researchers found the mean reduction in AHI was greater with liraglutide than with placebo (–12.2 vs –6.1 events per hour; P = .015). Most of the reduction in mean AHI occurred by week 12, with minimal change thereafter, according to researchers. Participants in the liraglutide group experienced greater mean percentage weight loss compared with placebo (–5.7 vs –1.6%; P < .0001).
In both treatment groups, researchers found greater weight loss was significantly associated with greater reduction in AHI in post hoc analysis. Participants in the liraglutide group saw greater reductions in HbA1c, fasting plasma glucose and systolic blood pressure vs. placebo (P < .001 for all). The safety profile of liraglutide 3.0 mg was similar to that seen with doses 1.8 mg and lower.
“This study suggests that liraglutide 3.0 mg in conjunction with a diet and exercise regimen may be useful as a weight management component of a comprehensive therapeutic approach for OSA management,” the researchers wrote. “Given its range of beneficial pharmacodynamic effects, liraglutide 3.0 mg may also be a useful tool in individuals already on CPAP treatment.” – by Regina Schaffer
Disclosure: Blackman reports serving as a consultant or advisory board participant for Novo Nordisk, Merck Canada, Paladin Labs Inc. and Valeant Canada. Please see the full study for the other authors’ relevant financial disclosures.
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