New research presented at this year’s European Congress on Obesity (ECO) in Prague, Czech Republic, shows that the drug liraglutide, now approved for treatment of obesity as well as for type 2 diabetes in Europe and the USA, reduces occurrence of sleep apnoea more effectively than placebo, most likely through its promotion of weight loss. The study is by Dr Gary Zammit, Clinilabs, New York, NY, USA, and colleagues.
This study of data collected in the SCALE Sleep Apnoea Trial which analysed the relationship weight loss, sleep apnoea and quality of life. Obese adults (72% male, mean age 49 years, apnoea-hypopnoea index [AHI] 49.2 events/hour, mean body weight [BW] 117.6 kg) with moderate or severe obstructive sleep apnoea (OSA) and unable/unwilling to use continuous positive airway pressure therapy were treated with liraglutide 3.0 mg (n=180) or placebo (n=179), both in addition to diet and exercise counselling, for 32 weeks.
The researchers found that liraglutide 3.0 mg reduced AHI (–12.2 vs –6.1 events/hour) and BW (-5.7% vs –1.6%) vs placebo after 32 weeks. They also found that AHI reduction was significantly associated with weight loss (WL), irrespective of treatment, suggesting that the weight loss effects of liraglutide were responsible for its association with improving sleep apnoea symptoms. The reduction in AHI per %WL depended on baseline AHI, with reductions of 0.7, 1.4 and 2.8 events/hour for base¬line AHI cohorts <30, 30–59 and =60 events/hour, respectively. Greater WL was also significantly associated with greater im¬provement in various quality of life factors, including reductions in feelings of sleepiness, improved blood oxygen saturation, and improved total sleep time.
The authors conclude: “Greater weight loss and reduction of sleep apnoea episodes were more likely with liraglutide 3.0 mg than placebo. Greater im¬provements in sleep apnoea endpoints and quality of life were significantly asso¬ciated with greater weight loss, irrespective of how the weight loss was achieved. The safety profile for liraglutide 3.0 mg was generally consistent with that seen with liraglutide in type 2 diabetes.”
According to Dr. Zammit, “Multiple trials have shown that weight loss is effective in reducing the sleep apnoea episodes in people with sleep apnoea, and should be considered an essential element of the treatment plan for overweight people with this condition.”