This gets cited here weekly, usually second-hand, so it is worth setting out what it does and does not establish.
The apnoea data is some of the strongest non-weight evidence in the class. SURMOUNT-OSA showed large reductions in apnoea-hypopnoea index on tirzepatide, with a meaningful fraction of participants improving enough to change their treatment category. Mechanistically it is upper-airway fat and reduced abdominal load rather than anything neurological, which is why the effect tracks weight loss closely.
Where I think it is weakest: the comparator does most of the work in how this gets reported, and it is not the comparator most people think they are citing.
What I am trying to establish is what people did about re-titration, because feeling better is not the same as a study saying you are better. Numbers rather than impressions, if you have them.
SleepDoc_PDX said:The apnoea data is some of the strongest non-weight evidence in the class.
Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.
Happy to go further on any of that.
SleepDoc_PDX said:The apnoea data is some of the strongest non-weight evidence in the class.
I read this differently from SleepDoc_PDX, on substance rather than tone. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.
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View ResultsThis one has a reasonably settled answer, so here it is. Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five. That matters when you are deciding whether a dose step has finished expressing itself.
VendorMark said:Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg.
This is my experience too, for whatever a second data point is worth. Nothing to add that would improve it.