GLUCAGON-LIKE PEPTIDE-1-BASED ANTI-OBESITY MEDICATIONS REDUCE INCIDENT OBSTRUCTIVE SLEEP APNEA IN OLDER ADULTS: REAL-WORLD EVIDENCE
Author(s)
Marjan Zakeri, MD, PhD1, Samuel Wagner, MPharm, PhD2, Nehir Yapar3, Erdem Baser, PhD4, Onur Baser, PhD5.
1Columbia Data Analytics, New York, NY, USA, 2Columbia Data Analytics, Newtown, PA, USA, 3Director of Data Science, Columbia Data Analytics, New York, NY, USA, 4Mergen Medical Research, Ankara, Turkey, 5City University of New York (CUNY), New York, NY, USA.
1Columbia Data Analytics, New York, NY, USA, 2Columbia Data Analytics, Newtown, PA, USA, 3Director of Data Science, Columbia Data Analytics, New York, NY, USA, 4Mergen Medical Research, Ankara, Turkey, 5City University of New York (CUNY), New York, NY, USA.
OBJECTIVES: Obstructive sleep apnea (OSA) disproportionately burdens older adults with obesity and generates substantial healthcare costs. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide/GLP-1 agonists have demonstrated metabolic and respiratory benefits. Real-world evidence evaluating their association with incident OSA in older populations remains limited. This study assessed the impact of semaglutide and tirzepatide on OSA incidence among Medicare-enrolled adults with obesity.
METHODS: A retrospective cohort study was conducted using Medicare Enhanced Laboratory and Demographics (MELDTM) database 2022-2024. Adults aged ≥65 years with obesity who initiated semaglutide or tirzepatide (anti-obesity medication [AOM] cohort) were compared with untreated individuals (no-AOM cohort). Eligibility required 12 months of baseline health plan enrollment, no prior OSA diagnosis and/or AOM use. Incident OSA was identified using ICD-10-CM code G47.33. Propensity score matching was performed on age, sex, socioeconomic status, Elixhauser comorbidity index score, and body mass index (BMI). Cox proportional hazards models estimated adjusted hazard ratios (HR). Secondary analyses compared semaglutide and tirzepatide directly, with stratification by BMI.
RESULTS: After applying inclusion/exclusion criteria, 23,796 AOM users (20,325 semaglutide; 3,471 tirzepatide) and 153,380 no-AOM individuals were identified. AOM use was associated with a significantly lower hazard of incident OSA vs no treatment (HR, 0.67; 95% CI, 0.64-0.69; p<0.0001). Male sex and higher BMI were independently associated with greater OSA risk. No significant difference was observed between semaglutide and tirzepatide (HR, 1.07; 95% CI, 0.96-1.19; p=0.2). BMI-stratified analyses confirmed no differential effect between agents across obesity classes.
CONCLUSIONS: In this large real-world cohort of older adults with obesity, semaglutide and tirzepatide use was associated with a 33% reduction in incident OSA risk relative to no pharmacologic treatment. Both agents conferred comparable protective effects, suggesting a class-level benefit. These findings support consideration of GLP-1-based pharmacotherapy as part of OSA prevention strategies in older adults.
METHODS: A retrospective cohort study was conducted using Medicare Enhanced Laboratory and Demographics (MELDTM) database 2022-2024. Adults aged ≥65 years with obesity who initiated semaglutide or tirzepatide (anti-obesity medication [AOM] cohort) were compared with untreated individuals (no-AOM cohort). Eligibility required 12 months of baseline health plan enrollment, no prior OSA diagnosis and/or AOM use. Incident OSA was identified using ICD-10-CM code G47.33. Propensity score matching was performed on age, sex, socioeconomic status, Elixhauser comorbidity index score, and body mass index (BMI). Cox proportional hazards models estimated adjusted hazard ratios (HR). Secondary analyses compared semaglutide and tirzepatide directly, with stratification by BMI.
RESULTS: After applying inclusion/exclusion criteria, 23,796 AOM users (20,325 semaglutide; 3,471 tirzepatide) and 153,380 no-AOM individuals were identified. AOM use was associated with a significantly lower hazard of incident OSA vs no treatment (HR, 0.67; 95% CI, 0.64-0.69; p<0.0001). Male sex and higher BMI were independently associated with greater OSA risk. No significant difference was observed between semaglutide and tirzepatide (HR, 1.07; 95% CI, 0.96-1.19; p=0.2). BMI-stratified analyses confirmed no differential effect between agents across obesity classes.
CONCLUSIONS: In this large real-world cohort of older adults with obesity, semaglutide and tirzepatide use was associated with a 33% reduction in incident OSA risk relative to no pharmacologic treatment. Both agents conferred comparable protective effects, suggesting a class-level benefit. These findings support consideration of GLP-1-based pharmacotherapy as part of OSA prevention strategies in older adults.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PT26
Topic
Clinical Outcomes, Health Service Delivery & Process of Care
Topic Subcategory
Clinical Outcomes Assessment
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)