Liraglutide reduces OSA severity in patients with COPD and obesity in exploratory analysis

Obstructive sleep apnea (OSA) is associated with chronic obstructive pulmonary disease (COPD) and obesity, and all three are linked to reduced health-related quality of life (HRQoL). Coexistence of OSA and COPD increases morbidity and mortality compared to each condition alone. Liraglutide, a glucagon-like peptide 1 receptor agonist, may influence respiratory and HRQoL outcomes. In this secondary exploratory analysis of a randomised controlled trial including individuals with overweight or obesity and COPD, we evaluated effects of liraglutide on OSA prevalence and severity, daytime sleepiness (Epworth Sleepiness Scale, ESS), and HRQoL (Short Form-36 version 2, SF-36v2). In a double-blinded randomised controlled trial, 40 participants with overweight or obesity and COPD from two outpatient clinics were randomised to liraglutide (3.0 mg, subcutaneous) or placebo for 40 weeks. Cardiorespiratory monitoring, SF-36v2 and ESS questionnaires were conducted at baseline and end of treatment. OSA was diagnosed in 84% of participants (70% in the liraglutide group and 85% in the placebo group). Compared to placebo, liraglutide significantly reduced OSA severity, with mean baseline-adjusted differences of -9.87 events/h (β 95% CI -19.5; -0.247, p = 0.044) in Apnea-Hypopnea Index and -10.16 events/h (β 95% CI -19.29; -1.03, p = 0.029) in Oxygen Desaturation Index. ESS scores did not change significantly. Significant improvements were observed in the SF-36v2 subdomains General Health Perception and Role Physical. OSA is common among individuals with overweight or obesity and COPD. Forty weeks of liraglutide treatment were associated with reduced OSA severity and improvements in selected HRQoL domains in this population.