B80-3-03 Cpap Use in the Era of Glp-1 and Dual Agonists in Patients With Obstructive Sleep Apnea: A Real-World Study

Abstract Rationale Use of glucagon-like peptide-1 (GLP-1) and dual agonists as anti-obesity medications has surged in recent years. Since obesity is the main risk factor for obstructive sleep apnea (OSA), it is conceivable that the increasing prescription of the approved drugs such as liraglutide, semaglutide and tirzepatide may impact the reports of the main treatment of OSA, namely continuous positive airway pressure (CPAP). We aimed to evaluate the trends of GLP-1 agonists (liraglutide and semaglutide) and dual agonists (tirzepatide) in parallel to the trends observed in CPAP initiation in patients with obesity and OSA. Methods We conducted a retrospective cohort analysis using the TriNetX Global Health Research Network through anonymized electronic medical records. We identified all adult patients (≥18 years) with a history of obesity and OSA (the latter using multiple code recommendations of the international Classification of Diseases 10th edition: G47.33, G47.3, G47.39 or G47.30) between 2018 and 2025. We excluded patients with other GLP-1 agonists not approved for obesity, orlistat, phentermine-topiramate, naltrexone-bupropion, bariatric surgery, patients with central sleep apnea and muscular dystrophy. We did a similar analysis with procedure codes of CPAP initiation. We calculated the incidence proportion (%), prevalence (%), and incident rate (cases/person-day) of GLP-1/dual agonists and CPAP. Results During this 8-year period, we observed a significant increase in the incidence proportion, prevalence and incident rate of GLP-1/dual agonists (Figure 1). In the same period, there was no indication of significant decreased in CPAP initiation rates (Figure 1). Results remained consistent in males and females. Despite increasing incidence trends for both treatments, we observed that only a small proportion of patients with obesity and OSA were on use of GLP-1/dual agonists and/or CPAP suggesting that other treatments or under documentation of treatment are potential explanations for this scenario. Conclusion In the era of GLP-1 and dual agonists for treating obesity, there is no current significant impact of CPAP initiation in patients with OSA. However, considering that tirzepatide, the only drug approved for OSA, was launched in June 2022, long-term impact of this medication on CPAP initiation deserves future analysis. This abstract is funded by: Hospital Sírio Libanês