Tirzepatide injection becomes the first medication authorized in Canada for moderate to severe OSA, demonstrating significant reductions in breathing disruptions in clinical trials.
Key takeaways:
- Health Canada approved Zepbound (tirzepatide injection) for adults with obesity and moderate to severe OSA.
- In clinical trials, adults taking Zepbound without PAP therapy had 25 fewer breathing disruptions per hour, and those on PAP therapy had 29 fewer.
- The medication is to be used alongside a reduced-calorie diet and increased physical activity.
Health Canada has approved Zepbound (tirzepatide injection) for the treatment of moderate to severe obstructive sleep apnea (OSA) in adults with obesity.
Marketed by Eli Lilly Canada, Zepbound is the first medication approved in Canada for this indication. It is authorized for use in combination with a reduced-calorie diet and increased physical activity in adults with a body mass index (BMI) of 30 or greater.
The medication works by activating receptors of hormones secreted from the intestine—glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)—to reduce appetite and food intake. By reducing body weight, studies show that Zepbound also improves OSA.
The approval is based on results from the SURMOUNT-OSA phase 3 clinical trials, which evaluated Zepbound (10 mg or 15 mg) over the course of a year in adults with and without positive airway pressure (PAP) therapy.
In adults unwilling or unable to use PAP therapy, Zepbound led to 25 fewer breathing disruptions per hour, compared to five fewer with a placebo. After one year, 42% of adults taking Zepbound without PAP therapy experienced remission or mild, non-symptomatic OSA, compared to 16% on placebo.
Among adults on PAP therapy, Zepbound led to 29 fewer breathing disruptions per hour, compared to six fewer with a placebo. In this group, 50% experienced remission or mild, non-symptomatic OSA after one year, compared to 14% on placebo.
“Zepbound’s approval for the treatment of obstructive sleep apnea in adults with obesity represents a significant advancement in obesity medicine,” says RJ Kamatovic, MD, CCFP, of Niagara Medical Wellness Clinic, in a release. “Sleep disruption contributes to a cascade of metabolic effects, including worsening insulin resistance, increased hunger and cravings, fatigue, and diminished weight-loss outcomes. For many patients, these factors create a self-perpetuating cycle that can be difficult to overcome. Despite the high prevalence of OSA among individuals living with obesity, CPAP adherence and long-term utilization remains challenging for many patients. Expanding treatment options that address both excess weight and OSA may help close an important gap in care.”
“For Canadians living with obesity and obstructive sleep apnea, this approval represents an important step toward care that recognizes the complex relationship between these chronic diseases,” says Lisa Schaffer, executive director of Obesity Canada, in a release. “Too often, stigma and blame stand in the way of people receiving the care they need. As science advances, we must ensure evidence-based treatments are not only available, but accessible—because innovation without access is inequity.”
“People living with obesity know better than anyone how one health challenge can ripple into every part of life, including sleep,” says Priti Chawla Karunakaran, executive director of Obesity Matters, in a release. “This approval means more Canadians can wake up rested, present, and ready to live fully. That matters.”
“Canadians living with obesity often face a complex set of health challenges, including conditions like obstructive sleep apnea,” says Mathilde Merlet, general manager and president of Lilly Canada, in a release. “As the first medication approved in Canada for moderate to severe OSA in adults with obesity, Zepbound represents an important new option for patients and clinicians. We will continue working with partners across the health system to support appropriate access and help ensure Canadians can benefit from this innovation.”
The US Food and Drug Administration approved Zepbound for moderate-to-severe OSA with obesity in December 2024.
