Topic summary

Obstructive sleep apnoea and a hard endpoint in this class

Clinical › Comorbidities chronic kidney disease PCOS obstructive sleep apnoea blood pressure

This is a generated summary. It shows the 9 most-liked posts from a topic of 130, in their original order, with the accepted answer included where one exists. It is a reading aid and it will miss nuance — the full topic is the record.

owen.bradyTL4 Moderator17 Jan 2025#1

On the subject in the title: Obstructive sleep apnoea and a hard endpoint in this class Working notes rather than a conclusion.

Asking about a population rather than about a person.

The published trials in this class mostly enrolled a fairly specific group, and the questions here frequently come from people well outside it. I would like to understand what the honest position is when someone falls outside the studied population: not "it is fine" and not "there is no data", but what the reasoning actually looks like.

27 likes 18mo

f.amankwahTL2 Moderator21 Jan 2025#2

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

29 likes 18mo

taper_shiftTL3Regular4 Mar 2025#26

da.bakker, post #11: Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables. Go to post

Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.

32 likes in reply to #11 17mo

j.cabreraTL2 Moderator12 Mar 2025 · edited#32

h.falk, post #19: Worth separating two things that post #15 runs together. Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone. Go to post

Obstructive sleep apnoea: SURMOUNT-OSA used an objective endpoint, the apnoea-hypopnoea index. Reduction was substantial. Whether the benefit is weight loss or a direct drug effect is not resolved by the trial.

29 likes in reply to #19 17mo

l.piresTL2 Moderator22 Mar 2025 · edited#39

Chronic kidney disease: compounds in this class have renal benefit in people with kidney disease. The benefit appears to be additive to other renal-protective agents, not a replacement for them.

30 likes in reply to #11 16mo

l.vukovicTL2 Moderator15 Apr 2025 · edited#59

b.jansen, post #27: This follows post #24 rather than contradicting it. Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone. Go to post

Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.

27 likes in reply to #27 15mo

c.kuuselaTL2 Moderator1 Jun 2025#101

MSaarinen, post #87: Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone. Go to post

Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.

30 likes in reply to #87 14mo

n.duarteTL2 Moderator15 Jun 2025#115

cannula_trace, post #12: Type 2 diabetes: the population with the largest evidence base for these compounds. The SURPASS and SUSTAIN programmes established glycaemic benefit. The renal and cardiovascular benefit evidence is separate from the glycaemic benefit evidence. Go to post

post #114 is right about the mechanism and I think understates the practical bit.

Hepatic steatosis and MASH: a phase 2 trial in semaglutide for steatohepatitis showed resolution was more frequent on treatment. Histological resolution is a surrogate for long-term clinical outcomes like cirrhosis.

32 likes in reply to #12 13mo

a.vermeulenTL2 Moderator28 Jun 2025#128

cannula_notes, post #89: This follows post #86 rather than contradicting it. PCOS and metabolic overlap: polycystic ovary syndrome has metabolic overlap with obesity and insulin resistance. Data on compounds in this class in PCOS specifically is thin; most discussion is by mechanism. Go to post

Comorbidity control: if a comorbidity (high blood pressure, high lipids) is not adequately controlled, the decision about adding compounds in this class depends on the current control status, not on the compound alone.

28 likes in reply to #89 13mo

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This topic was referenced in

Revisiting: PCOS and metabolic overlap: what is and is not studiedClinical › Comorbidities · 59 replies

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