0621 Glucagon-Like Peptide 1 Receptor Agonist and Positive Airway Pressure Use in Patients with OSA and Obesity

Abstract Introduction Obstructive sleep apnea (OSA) and obesity are strongly associated and highly prevalent in the United States (US). Routine treatment for OSA often includes positive airway pressure (PAP) therapy combined with weight management strategies, more recently including use of glucagon-like peptide 1 (GLP-1) receptor agonists. This real-world analysis assessed the impact of recent GLP-1 use on PAP therapy use over 1 year in non-diabetic patients with PAP-treated OSA and obesity. Methods Administrative claims data from January 2014-May 2023 linked to objective PAP usage data were analyzed. Commercially- or Medicaid insured non-diabetic adults (18-64 years) with OSA and obesity, ≥1 year of claims data before and after PAP setup (index date), and ≥1 year of PAP therapy data post index were included. Patients who filled a GLP-1 prescription within 90 days prior to index were considered recent GLP-1 users. Other GLP-1 users were excluded. PAP therapy adherence was categorized as adherent, intermediately adherent, or non-adherent based on objective usage over 1 year. PAP discontinuation was defined as >30 consecutive days with no use. Inverse probability of treatment weighting was used to balance groups on baseline covariates to compare PAP use over 1 year for OSA patients with and without a recent GLP-1 fill prior to index. Results A total of 267,794 patients with OSA were included (mean age 47.7 years; 44.1% female), of which 1,137 (0.43%) were recent GLP-1 users at index. Recent GLP-1 users were more commonly female (66.6% vs 44.0%), commercially insured (82.2% vs 77.7%), and with class III obesity (67.5% vs 46.8%) than those without a recent GLP-1 prescription fill. Average hours/day of PAP use at 1 year did not differ significantly between groups (3.80 vs 3.96). There was no significant difference in PAP adherence rates (adherent: 42.1% vs 45.1%; intermediately adherent: 29.5 vs 28.4%; non-adherent: 28.5 vs 26.5%) or PAP discontinuation (43.9% vs 41.7%) for those with and without recent GLP-1 use prior to index. Conclusion PAP use was similar among non-diabetic patients with OSA and obesity who did and did not have recent GLP-1 use prior to PAP. Support (if any) ResMed