A79-05 The Impact of Tirzepatide Induced Weight Loss on Lung Hyperinflation and AHI Reduction in COPD-OSA Overlap Syndrome

Abstract Background Static lung volumes have an important impact on upper airway patency through chest wall linkages to the trachea. Hyperinflation noted by imaging is thought to be protective for upper airway patency in patients with COPD-OSA Overlap. Tirzepatide has been shown to impact significantly OSA related outcomes through weight change. Weight loss in COPD patients has variable impact on static lung volumes (RV/TLC) but the impact of these changes in COPD-OSA Overlap patients remains unclear. We prospectively studied the impact of Tirzapitide induced weight loss on the change in static lung volumes and AHI in obese patients with both COPD and OSA. We hypothesized that increases in RV/TLC, a measure of lung hyperinflation, would be associated with improvements in OSA severity as measured by the apnea-hypopnea index, AHI. Results 34 patients were identified from a clinic based sample. 21 patients had complete data sets with COPD-OSA Overlap and were followed on Tirzatide (dose range 5-15 mg), for an average of 10.4±1.3 (mean±SEM) months of therapy to date. Anthropomorphic, sleep study and pulmonary function parameters are listed in Table 1 below (mean± SEM). CPAP was used by 69% of the cohort w mean PAP level of 10.7±0.75 cm H20. All patients lost weight on Tirzepitide (mean 8.45±1.1kg). Weight loss (percent change) was not correlated with change in AHI% (R, p = .82). When weight loss led to an increase in hyperinflation (RV/TLC%), there was an association (R2= 0.37, p = 0.008), Fig 1. Of note change in RV/TLC% was inversely correlated as well with inspiratory capacity- (IC/TLC%) change after weight loss, an additional marker hyperinflation (R2= 0.388, p 0.008). There was no impact of FEV1%, CPAP status, active smoking status or age on the differences of RV/TLC observed. Conclusions This pilot study suggests that changes in hyperinflation are variable in patients with COPD-OSA overlap but when weight loss leads to increased hyperinflation there may be a benefit in reducing OSAS severity. Funding: none. Table 1, Fig 1 below. This abstract is funded by: None