Obstructive sleep apnea (OSA) affects more than 25 million Americans and hundreds of millions more around the globe.
It is characterized by repetitive partial or complete upper airway obstructions that occur during sleep, resulting in intermittent hypoxemia, loud snoring, sleep disruption, and daytime sleepiness or fatigue. OSA is associated with metabolic and cardiovascular co-morbidities and possibly increased mortality and can impair work productivity, reduce functional ability, and lower quality of life.
- Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014 Feb 22;383(9918):736-47.
- Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, Nunez CM, Patel SR, Penzel T, Pépin JL, Peppard PE, Sinha S, Tufik S, Valentine K, Malhotra A. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019 Aug;7(8):687-698
CHALLENGES & OPPORTUNITIES IN
The Management of OSA
It is important to diagnose and treat Obstructive Sleep Apnea, as it can have serious long-term health consequences.
Current treatment options are either cumbersome or uncomfortable to use yielding reduced adherence, or are unpredictable in their efficacy. In addition, most clinical metrics used today to define apnea severity have problems in their measurement and ability to predict adverse outcomes.
- Azarbarzin A, Sands SA, Stone KL, Taranto-Montemurro L, Messineo L, Terrill PI, Ancoli-Israel S, Ensrud K, Purcell S, White DP, Redline S, Wellman A. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur Heart J. 2019 Apr 7;40(14):1149-1157
- Malhotra A, Ayappa I, Ayas N, Collop N, Kirsch D, Mcardle N, Mehra R, Pack AI, Punjabi N, White DP, Gottlieb DJ; for SRS task force. Metrics of Sleep Apnea Severity: Beyond the AHI. Sleep. 2021 Mar 9
Apnimed is developing oral pharmaceutical treatments for OSA.
Apnimed’s lead product candidate, AD109, represents a novel pharmacological approach that is specifically designed to target the neurological control and activation of upper airway dilator muscles to maintain an open airway during sleep. If approved, AD109 would be the first medication indicated to address the disordered nighttime breathing that characterizes obstructive sleep apnea.
- Taranto-Montemurro L, Messineo L, Sands SA, Azarbarzin A, Marques M, Edwards BA, Eckert DJ, White DP, Wellman A. The Combination of Atomoxetine and Oxybutynin Greatly Reduces Obstructive Sleep Apnea Severity. A Randomized, Placebo-controlled, Double-Blind Crossover Trial. Am J Respir Crit Care Med. 2019 May 15;199(10):1267-1276
- Taranto-Montemurro L, Messineo L, Wellman A. Targeting Endotypic Traits with Medications for the Pharmacological Treatment of Obstructive Sleep Apnea. A Review of the Current Literature. J Clin Med. 2019 Nov 2;8(11):1846
- Perger, Elisa and Taranto Montemurro, Luigi and Rosa, Debora and Vicini, Stefano and Marconi, Mariapaola and Zanotti, Lucia and Meriggi, Paolo and Azarbarzin, Ali and Sands, Scott A. and Wellman, Andrew and Lombardi, Carolina and Parati, Gianfranco, Reboxetine Plus Oxybutynin for Obstructed Sleep Apnea Treatment. A 1-Week Randomized, Placebo-Controlled, Double-Blind Crossover Trial.
- L. Thomson, S. Landry, S. A. Joosten, A. Wong, T. Cheung, C. Beatty, G. Hamilton, B. A. Edwards; Monash University, Melbourne, Australia, Monash Lung and Sleep, Monash Health, Clayton, Australia. A Randomized, Placebo-Controlled, Double-Blind Crossover Trial Assessing the Combination of Noradrenergic/Serotonergic Reuptake Inhibitor and an Antimuscarinic Agent for the Treatment of Obstructive Sleep Apnea. Am J Respir Crit Care Med 2020;201:A4521.