Breaking Ground: From CPAP Treatment to the First Medicine for OSA Patients with Obesity

Current Pulmonology Reports, Journal Year: 2025, Volume and Issue: 14(1)

Published: Jan. 11, 2025

Abstract Purpose of Review Pharmacologic alternatives in management obstructive sleep apnea (OSA) have been pursued for decades. Considering rapid development and promising findings recent years, we provide an overview novel agents treatment targets, ongoing trials, as well future perspectives. Recent Findings Several drugs demonstrate efficacy, though none is sufficient to cure the disease a monotherapy. Instead, main potential lies applying drug therapy specific subgroups or addition established treatments (e.g., positive airway pressure, oral appliance therapy). Glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists may be particularly beneficial obese OSA patients. As major breakthrough, terzipatide, GIP analog GLP-1 agonist, has become first FDA-approved EMA-sanctioned pharmacologic option individuals. Beyond this, alerting could help manage residual daytime sleepiness improve functioning. However, long-term studies on safety, adherence, effectiveness are scarce highlight certain limitations challenges. Summary Incorporating pharmaceuticals along conventional synergy benefit patients, but side-effects risk reduction related adverse outcomes over time yet assessed. Furthermore, guidelines/frameworks mapping out applicable targets needed.

Language: Английский

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Drug interactions of carbonic anhydrase inhibitors and activators

Expert Opinion on Drug Metabolism & Toxicology, Journal Year: 2024, Volume and Issue: 20(3), P. 143 - 155

Published: March 3, 2024

Introduction Carbonic anhydrases (CAs, EC 4.2.1.1) have been established drug targets for decades, with their inhibitors and activators possessing relevant pharmacological activity applications in various fields. At least 11 sulfonamides/sulfamates are clinically used as diuretics, antiglaucoma, antiepileptic, or antiobesity agents one derivative, SLC-0111, is clinical trials antitumor/antimetastatic agent. The were less investigated no

Language: Английский

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The association between the effective apnea-hypopnea index and blood pressure reduction efficacy following CPAP/oxygen treatment

Sleep Medicine, Journal Year: 2024, Volume and Issue: 117, P. 46 - 52

Published: March 13, 2024

Language: Английский

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Treatable Traits-Based Pharmacologic Treatment of Sleep Apnea

Sleep Medicine Clinics, Journal Year: 2024, Volume and Issue: 20(1), P. 103 - 114

Published: Dec. 10, 2024

Language: Английский

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REM sleep breathing: Insights beyond conventional respiratory metrics

Journal of Sleep Research, Journal Year: 2024, Volume and Issue: unknown

Published: July 3, 2024

Summary Breathing and sleep state are tightly linked. The traditional approach to evaluation of breathing in rapid eye movement has been focus on apneas hypopneas, associated hypoxia or hypercapnia. However, offers novel insights into physiology pathology, secondary complex interactions cardiorespiratory biology. In this review, morphological analysis clinical polysomnogram data assess respiratory patterns associations across a range health disease is presented. There several relatively unique that may be evident by assessment during sleep. These include the original discovery scoring neonatal sleep, control homeostasis, apnea endotyping pharmacotherapy, stability, non‐electroencephalogram staging, influences cataplexy, mimics behaviour disorder, reflection autonomic health, cardiac arrhythmogenesis. summary, there rich clinically actionable information beyond encoded

Language: Английский

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The Present and Future of the Clinical Use of Physiological Traits for the Treatment of Patients with OSA: A Narrative Review

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(6), P. 1636 - 1636

Published: March 13, 2024

People with obstructive sleep apnea (OSA) are a heterogeneous group. While many succeed in the treatment of their OSA, others struggle therapy. Herein, we discuss how anatomical and physiological factors that cause (OSA traits) impact response may offer an avenue for more precise care. These OSA traits, including (upper-airway collapsibility) (loop gain, airway muscle responsiveness, arousal threshold) factors, help determine who can continuous positive pressure, oral appliances, hypoglossal nerve stimulation, or pharmacotherapy. In future, identifying traits before initiating guide selection most effective tolerable therapy modalities each individual.

Language: Английский

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Novel physiologic predictors of positive airway pressure effectiveness (NICEPAP) study: rationale, design and methods

Sleep And Breathing, Journal Year: 2024, Volume and Issue: 28(5), P. 2005 - 2015

Published: July 12, 2024

Language: Английский

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Pharmacological management of co-morbid obstructive sleep apnoea and insomnia

Expert Opinion on Pharmacotherapy, Journal Year: 2023, Volume and Issue: 24(18), P. 1963 - 1973

Published: Dec. 12, 2023

Introduction Clinical presentation of both insomnia and obstructive sleep apnea (COMISA) is common. Approximately 30% clinical cohorts with OSA have symptoms vice versa. The underlying pathophysiology COMISA multifactorial. This poses a complex challenge. Currently, there are no guidelines or recommendations outside continuous positive airway pressure (CPAP) therapy cognitive behavioral for (CBTi). Clinically translatable precision medicine approaches to characterize individual causes endotypes may help optimize future pharmacological management COMISA.

Language: Английский

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Enhanced expiratory rebreathing space for high loop gain sleep apnea treatment

Frontiers in Sleep, Journal Year: 2023, Volume and Issue: 2

Published: Sept. 29, 2023

The pathophysiology of sleep apnea goes beyond anatomic predisposition to airway collapse and includes additional factors such as arousal threshold loop gain. High gain is a prominent feature in central complex (with mixture obstructive features) where relative hypocapnia can lead respiratory instability periodic breathing. Existing therapies, including continuous positive pressure (CPAP) adaptive servo-ventilators, often inadequately treat with high features. Enhanced expiratory rebreathing space (EERS) targets prevention the that triggers events by increasing dead amounts less than typical tidal volumes. This accomplished covering traditional exhalation ports on masks adding small tubing distal safety valves. technique reduces carbon dioxide (CO 2 ) blow-off during arousals associated large recovery breaths, typically producing maximal increase resting CO 1–2 mmHg, thus reserve making it likely encounter hypocapnic apneic threshold. Typically, amount EERS titrated response breathing rather aiming for goal level. Ideally monitoring used titration avoided setting baseline hypercapnia. method has been clinical practice at our center over 15 years, retrospective data suggests an excellent profile rates successful therapy patients who have previously failed CPAP therapy. Limitations include decreased effectiveness leak tolerance bulkier circuit. represents simple, affordable modification existing modalities treatment apnea. Areas future study randomized controlled trials use combination ventilation, pharmacologic adjuncts targeting physiology.

Language: Английский

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Acetazolamide as a Therapeutic Alternative for Central Sleep Apnea in Pediatric Patient with FBXO28 Gene Mutation: A case report and Review of Literature.

Sleep Medicine, Journal Year: 2024, Volume and Issue: 124, P. 479 - 482

Published: Oct. 18, 2024

Language: Английский

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