Adding tirzepatide to lifestyle modification in a lifetime model avoided 21 strokes, 23 CHD cases, and 80 type 2 diabetes cases per 1000 patients, yielding 4.8 additional months of life.
Does tirzepatide alongside lifestyle modification reduce major clinical events and mortality in adults with moderate-to-severe OSA and obesity?
In a lifetime modelling study, adding tirzepatide to lifestyle modification in Chinese patients with moderate-to-severe OSA and obesity was estimated to significantly reduce major clinical events and increase life expectancy.
Abstract Introduction Obstructive sleep apnea (OSA) is associated with increased risk of stroke, coronary heart disease (CHD), resistant hypertension (RH), type 2 diabetes (T2D), depression, cancer, and road traffic accidents (RTA). We aimed to examine tirzepatide, a dual GLP-1/GIP receptor agonist, alongside lifestyle modification (LM) for its potential to improve clinical outcomes in patients with moderate-to-severe OSA and obesity. Methods A cohort-based Markov model was constructed to track clinical outcomes over a lifetime horizon in adults with moderate-to-severe OSA and obesity, with health states defined by apnea-hypopnea index categories to capture the full spectrum of OSA severity. Transition probabilities were derived from the SURMOUNT-OSA trial, assuming extrapolation beyond trial period. Simultaneously, average body mass index (BMI) was modelled across cycles to reflect weight changes over time. The model integrated baseline characteristics from East Asian patients of the SURMOUNT-OSA trial, and risks for complications sourced from general population data in China and adjusted for BMI-related risk amplification. Age- and gender-specific background mortality rates were included, along with OSA-specific mortality linked to stroke, CHD, and RTA. The direct impact of BMI on mortality was also incorporated. Results Over a lifetime simulation, the estimated clinical burden under LM alone was substantial, with the following number of non-fatal events per 1000 patients: 127 strokes, 179 cases of CHD, 161 cases of RH, 235 cases of T2D, 507 cases of depression, 71 cases of cancer, and 333 RTA. Adding tirzepatide to LM significantly reduced the clinical burden, avoiding approximately 21 strokes (-17%), 23 cases of CHD (-13%), 20 cases of RH (-12%), 80 cases of T2D (-34%), 20 cases of depression (-4%), 10 cases of cancer (-14%), and 46 RTA (-14%) per 1000 patients. Cumulative mortality was also lower with tirzepatide yielding approximately 4.8 additional months of life. Conclusion In this lifetime modelling study, tirzepatide, in addition to LM, was estimated to reduce the incidence of major clinical events and mortality in patients with moderate-to-severe OSA and obesity in China. These findings, robust across sensitivity analyses, support the clinical and public health value of tirzepatide in this high-risk population. Support (if any) Sponsored by Eli Lilly and Company.
Xiao et al. (2026) studied Moderate-to-severe OSA and obesity. Tirzepatide vs. Lifestyle modification (LM) alone was evaluated on Incidence of major clinical events and mortality over a lifetime horizon. Adding tirzepatide to lifestyle modification in a lifetime model avoided 21 strokes, 23 CHD cases, and 80 type 2 diabetes cases per 1000 patients, yielding 4.8 additional months of life.