{
 "page": "https://jabbitapp.com/research/retatrutide-sleep-apnea-vs-zepbound-triumph-osa-teardown.html",
 "checked": "2026-10-27",
 "note": "Quotes asserted against cached copies. NEJM article cited by DOI 10.1056/NEJMoa2611477. Table columns: retatrutide 4, 9, 12 mg, placebo (TRIUMPH-1-OSA) then the same for TRIUMPH-2-OSA. Cross-trial chart values are from different trials (52 vs 80 weeks, different populations and estimands) and are not a head-to-head comparison.",
 "nejm_quotes": [
  "This article was published on October 21, 2026, at NEJM.org.",
  "DOI: 10.1056/NEJMoa2611477",
  "Presented at the 28th Congress of the European Sleep Research Society, October 20–23, 2026.",
  "Supported by Eli Lilly.",
  "The sponsor (Eli Lilly) designed and oversaw the conduct of the trials",
  "A total of 243 participants underwent randomization in TRIUMPH-1-OSA and 448 in TRIUMPH-2-OSA.",
  "The baseline mean AHI was 58.6 and 55.9 events per hour, respectively, and the mean body weight was 119.6 and 115.9 kg.",
  "a hybridtreatment estimand was applied",
  "We also report intention-to-trea",
  "The effects of retatrutide at a dose of 4 mg did not reach statistical significance under the testing hierarchy in either trial for these end points.",
  "in such participants, PAP therapy may no longer be recommended.",
  "The observed reductions in the AHI with retatrutide are similar to those associated with this degree of weight loss in meta-analyses",
  "patients with OSA who had a BMI below 27 were not included.",
  "On average, the participants had a low-to-mild sleep-related symptom burden at baseline, which limits generalizability.",
  "The current trials do not provide information on long-term cardiovascular outcomes.",
  "The potential effect of treatment interventions on adherence to PAP treatment was not measured.",
  "Prospective studies are needed to determine whether reductions in the hypoxic burden in both TRIUMPH-OSA trials translate into improved long-term cardiovascular outcomes.",
  "Although studies have shown reductions in cardiovascular morbidity and mortality with the use of PAP,23 these reductions have not been shown in randomized, controlled trials.",
  "Dysesthesias were reported more frequently with retatrutide than with placebo in both trials.",
  "Serious adverse events were reported by 14 participants (8%) who received retatrutide and 6 participants (10%) who received placebo in TRIUMPH-1-OSA; the corresponding numbers in TRIUMPH-2-OSA were 28 (8%) and 11 (10%).",
  "the peak increase was 5 to 7 beats per minute across the trials",
  "One participant in TRIUMPH-2-OSA died during receipt of retatrutide at the 9-mg dose",
  "There were no cases of medullary thyroid cancer or druginduced liver injury.",
  "occurred most frequently during dose escalation"
 ],
 "nejm_table2": {
  "ahi_change": [
   "−22.9",
   "−34.3",
   "−31.7",
   "−9.9",
   "−19.2",
   "−24.7",
   "−25.4",
   "−10.3"
  ],
  "ahi_pct": [
   "−38.5",
   "−57.3",
   "−53.3",
   "−11.1",
   "−27.6",
   "−39.5",
   "−40.9",
   "−13.3"
  ],
  "ahi_50": [
   "45.9",
   "65.7",
   "61.4",
   "23.9",
   "39.1",
   "52.3",
   "52.5",
   "24.4"
  ],
  "remission_mild": [
   "26.3",
   "51.6",
   "42.3",
   "12.5",
   "24.3",
   "39.5",
   "38.9",
   "12.6"
  ],
  "weight_pct": [
   "−12.5",
   "−22.2",
   "−20.6",
   "−4.8",
   "−12.1",
   "−17.9",
   "−18.5",
   "−5.6"
  ],
  "sashb_pct": [
   "−56.4",
   "−75.0",
   "−70.2",
   "−25.5",
   "−43.9",
   "−62.8",
   "−64.1",
   "−30.0"
  ]
 },
 "nejm_table2_placebo_diff_ahi": [
  "−13.0",
  "−24.4",
  "−21.9",
  "−8.9",
  "−14.4",
  "−15.1"
 ],
 "nejm_table3": {
  "Any adverse event after the start of treatment": [
   "56 (93)",
   "56 (92)",
   "53 (88)",
   "47 (76)",
   "85 (73)",
   "86 (79)",
   "92 (84)",
   "80 (71)"
  ],
  "Serious adverse event": [
   "6 (10)",
   "1 (2)",
   "7 (12)",
   "6 (10)",
   "5 (4)",
   "12 (11)",
   "11 (10)",
   "11 (10)"
  ],
  "Adverse event leading to discontinuation of": [
   "4 (7)",
   "0",
   "5 (8)",
   "4 (6)",
   "3 (3)",
   "10 (9)",
   "2 (2)",
   "4 (4)"
  ],
  "Diarrhea": [
   "18 (30)",
   "27 (44)",
   "21 (35)",
   "9 (15)",
   "29 (25)",
   "40 (37)",
   "38 (35)",
   "11 (10)"
  ],
  "Dysesthesia (skin burning sensation or": [
   "1 (2)",
   "8 (13)",
   "5 (8)",
   "1 (2)",
   "5 (4)",
   "5 (5)",
   "8 (7)",
   "0"
  ],
  "Death": [
   "0",
   "0",
   "0",
   "2 (3)",
   "0",
   "1 (1)",
   "0",
   "1 (1)"
  ]
 },
 "pubmed_abstract_quotes": {
  "42814954": [
   "The mean percent change in body weight in the retatrutide groups was -17.6% (4-mg dose), -23.7% (9-mg dose), and -25.0% (12-mg dose) versus -3.9% in the placebo group",
   "the change in the apnea-hypopnea index in the 243 participants with obstructive sleep apnea"
  ],
  "42810372": [
   "We aimed to assess the efficacy and safety of retatrutide in adults with obesity and type 2 diabetes."
  ],
  "41090431": [
   "A novel basket trial design simultaneously evaluates retatrutide treatment across these multiple adiposity-related disease states."
  ],
  "38912654": [
   "In trial 1, the mean change in AHI at week 52 was -25.3 events per hour",
   "with placebo, for an estimated treatment difference of -20.0 events per hour",
   "for an estimated treatment difference of -23.8 events per hour",
   "(Funded by Eli Lilly; SURMOUNT-OSA ClinicalTrials.gov number, NCT05412004.)"
  ],
  "31300334": [
   "425 million (399-450) adults aged 30-69 years have moderate to severe obstructive sleep apnoea globally",
   "ResMed."
  ],
  "27571048": [
   "the mean duration of adherence to CPAP therapy was 3.3 hours per night",
   "hazard ratio with CPAP, 1.10; 95% confidence interval, 0.91 to 1.32; P=0.34",
   "did not prevent cardiovascular events in patients with moderate-to-severe obstructive sleep apnea and established cardiovascular disease",
   "CPAP significantly reduced snoring and daytime sleepiness and improved health-related quality of life and mood."
  ]
 },
 "zepbound_label_quotes": [
  "to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity.",
  "Patients with type 2 diabetes mellitus were excluded",
  "The clinical studies for OSA did not evaluate the timing or appropriateness of PAP discontinuation in patients who were previously compliant with PAP therapy.",
  "Change from baseline b -5.3 -25.3 -5.5 -29.3",
  "Difference from placebo b (95% CI) -20 (-25.8, -14.2) e -23.8 (-29.6, -17.9) e",
  "% of Patients with AHI <5 or AHI 5-14 and ESS≤10 d 15.9 42.2 14.3 50.2",
  "% change from baseline b -1.6 -17.7 -2.3 -19.6",
  "(BMI ≥30 kg/m 2 )",
  "of 52 weeks duration"
 ],
 "fda_2024_quotes": [
  "For Immediate Release: December 20, 2024",
  "Today’s approval marks the first drug treatment option for certain patients with obstructive sleep apnea",
  "The improvement in AHI in participants with OSA is likely related to body weight reduction with Zepbound."
 ],
 "medscape_2026_10_26_quotes": [
  "October 26, 2026",
  "He noted that without head-to-head trials it’s not possible to know whether retatrutide offers any advantages over tirzepatide.",
  "“We don’t want to miss residual OSA,” she said",
  "She recommended repeat sleep testing after significant weight loss to guide future treatment decisions.",
  "One case of adjudication-confirmed pancreatitis occurred with retatrutide.",
  "Patel reported receiving consulting fees from Apnimed, SleepRes, Bayer Pharmaceuticals, and Powell Mansfield, among other industry relationships.",
  "Gurubhagavatula had no relevant disclosures."
 ],
 "lilly_2026_07_23_quotes": [
  "support global submissions for retatrutide as a potential treatment for obesity, knee osteoarthritis pain, and obstructive sleep apnea",
  "plans to submit a Biologics License Application (BLA) for retatrutide to FDA in Q1 2027"
 ],
 "clinicaltrials_gov": {
  "NCT05929066": {
   "title": "A Study of Retatrutide (LY3437943) in Participants Who Have Obesity or Overweight",
   "status": "COMPLETED",
   "enrollment": 2335,
   "primary_completion": "2026-04-06"
  },
  "NCT05929079": {
   "title": "A Study of Retatrutide (LY3437943) in Participants With Type 2 Diabetes Mellitus Who Have Obesity or Overweight",
   "status": "COMPLETED",
   "enrollment": 1152,
   "primary_completion": "2026-06-16"
  },
  "NCT06383390": {
   "title": "The Effect of Retatrutide Once Weekly on Cardiovascular Outcomes and Kidney Outcomes in Adults Living With Obesity (TRIUMPH-Outcomes)",
   "status": "ACTIVE_NOT_RECRUITING",
   "enrollment": 10000,
   "primary_completion": "2029-02"
  }
 },
 "chart_data": {
  "placebo_adjusted_ahi": [
   [
    "Zepbound, SURMOUNT-OSA trial 1 (no PAP), 52 wk",
    -20.0
   ],
   [
    "Zepbound, SURMOUNT-OSA trial 2 (on PAP), 52 wk",
    -23.8
   ],
   [
    "Retatrutide 9 mg, TRIUMPH-1-OSA, 80 wk",
    -24.4
   ],
   [
    "Retatrutide 12 mg, TRIUMPH-1-OSA, 80 wk",
    -21.9
   ],
   [
    "Retatrutide 9 mg, TRIUMPH-2-OSA (type 2 diabetes), 80 wk",
    -14.4
   ],
   [
    "Retatrutide 12 mg, TRIUMPH-2-OSA (type 2 diabetes), 80 wk",
    -15.1
   ]
  ],
  "remission_mild_pct": [
   [
    "SURMOUNT-OSA trial 1",
    15.9,
    42.2
   ],
   [
    "SURMOUNT-OSA trial 2",
    14.3,
    50.2
   ],
   [
    "TRIUMPH-1-OSA, 9 mg",
    12.5,
    51.6
   ],
   [
    "TRIUMPH-1-OSA, 12 mg",
    12.5,
    42.3
   ],
   [
    "TRIUMPH-2-OSA, 9 mg",
    12.6,
    39.5
   ],
   [
    "TRIUMPH-2-OSA, 12 mg",
    12.6,
    38.9
   ]
  ]
 }
}