Weekly Retatrutide Shots Ease Sleep Apnea in Two Phase 3 Trials
Two 80-week trials in adults with obesity found that three doses of the experimental injection cut breathing pauses more than placebo, with and without type 2 diabetes.
An experimental once-weekly injection called retatrutide reduced breathing interruptions during sleep more than placebo in two phase 3 trials, according to results published in the New England Journal of Medicine.
The trials, named TRIUMPH-1-OSA and TRIUMPH-2-OSA, enrolled adults who were overweight or living with obesity and had moderate-to-severe obstructive sleep apnea. The first included people without type 2 diabetes, the second people with it. Participants were randomly split into four equal groups and received weekly injections of retatrutide at 4 mg, 9 mg or 12 mg, or a placebo. To qualify, they needed a body mass index of at least 27 and at least 15 breathing pauses per hour of sleep.
What the trials found
After 80 weeks, all three doses cut breathing interruptions more than placebo, including in participants with diabetes. At the two higher doses, pauses fell by an average of 25 per hour, roughly 40%, against 10 fewer in the placebo group.
Among people on the higher doses, 39% to 52% saw their sleep apnea improve to no disease or mild disease without excessive daytime sleepiness. In the placebo group the figure was about 13%.
At the 4 mg dose, breathing pauses dropped by an average of 23 per hour, and participants lost an average of 12.5% of their body weight. For 52% to 66% of participants without diabetes on the 9 mg or 12 mg doses, interruptions fell by at least half.
In the diabetes trial, participants lost 18% to 19% of their weight on average, compared with about 6% on placebo. Up to 52% of those without diabetes and 40% of those with diabetes reached normal breathing or only mild sleep apnea. At those levels, the report says, they might no longer need a CPAP machine.
The treatment ran about a year and a half. At the start, at week 24 and at week 80, participants spent a night in a sleep clinic for full assessments by polysomnography.
How retatrutide works
Retatrutide is being developed to treat obesity and type 2 diabetes. It activates three hormone receptors at once, which makes it a triple receptor agonist. Semaglutide, sold as Wegovy, targets one hormone, and tirzepatide, sold as Zepbound, targets two.
By mimicking GLP-1 and GIP, retatrutide helps lower blood sugar, promotes fullness and improves the body's insulin response. GIP also helps reduce body weight alongside GLP-1. By acting on glucagon receptors, the drug increases energy expenditure and metabolic activity.
The standard treatment for sleep apnea is a continuous positive airway pressure mask, known as CPAP, which many people find uncomfortable and struggle to wear every night. If approved, retatrutide could become another option for people with obesity and sleep apnea, including those who also have type 2 diabetes.
Source: Medical Xpress