Clinical Impact of Tirzepatide on Patients With OSA and Obesity.

BACKGROUND: OSA is a prevalent chronic condition linked to obesity that is associated with increased risks of cardiovascular and kidney disease. Although weight loss can improve OSA outcomes, additional effective therapeutic options are needed. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has shown promise in promoting significant weight loss and reducing OSA severity. RESEARCH QUESTION: Does tirzepatide affect clinical outcomes in individuals with OSA and obesity? STUDY DESIGN AND METHODS: This study was conducted using the TriNetX Global Collaborative Network and included adults with OSA and obesity between January 1, 2022, and November 30, 2024. Patients were divided into 2 groups: those prescribed tirzepatide (study group) and those receiving lifestyle interventions (control group). Propensity score matching (PSM) was applied to balance covariates. The primary outcome was all-cause mortality, with secondary outcomes including major adverse cardiovascular events (MACEs) and major adverse kidney events (MAKEs). RESULTS: After PSM, the study included 42,300 patients (21,150 patients in each group). The tirzepatide group was associated with a lower risk of all-cause mortality (hazard ratio [HR], 0.443 [95% CI, 0.336-0.583]). Tirzepatide use also was associated with reduced risks of MACEs (HR, 0.731 [95% CI, 0.622-0.859]) and MAKEs (HR, 0.427 [95% CI, 0.343-0.530]). Except for the group 18 to 39 years of age, these associations remained consistent across all other subgroups when stratified by age, sex, BMI, and CPAP use. Sensitivity analyses supported the robustness of these findings. INTERPRETATION: Tirzepatide could be associated with reduced mortality, cardiovascular events, and kidney-related complications in patients with OSA and obesity. These findings suggest that tirzepatide may be a potential therapeutic option for improving clinical outcomes in this population.