ERS 2024: Epilepsy drug shows promise for treating obstructive sleep apnea

September 12, 2024

In a double-blind, randomized, placebo-controlled trial involving patients with obstructive sleep apnea (OSA), the carbonic anhydrase inhibitor sulthiame (STM; currently used as anticonvulsant outside of the U.S.) improved sleep quality, hypoxia, and daytime sleepiness while also reducing sleep disordered breathing. The findings were presented at the recent European Respiratory Society Congress in Vienna, Austria.

• STM was evaluated in 298 patients (26.2% female; mean age, 56 years) with OSA who weren't tolerating or refused to use CPAP or oral splints. Participants were randomized to 100 mg, 200 mg, or 300 mg of STM or placebo and were assessed by polysomnography at baseline, one month, and three months.
• Patients in the STM group had fewer pauses in their breathing and higher levels of oxygen in their blood during sleep. The AHI3a (measure of the frequency of respiratory pauses during sleep) change from baseline to week 15 was 17.8%, 34.8%, and 39.9% lower for the 100 mg, 200 mg, and 300 mg groups, respectively.
• The AHI4 measure (apnea/hypopnea with ≥4% O2 desaturation) showed that STM treatment led to a nearly 50% reduction of respiratory pauses that were associated with more profound lowering of oxygen levels. OSA patients in the STM group also reported less daytime sleepiness.
• Adverse events (paresthesia, headache, fatigue, and nausea) were mostly mild-to-moderate and dose dependent. No cardiovascular safety issues were detected.

Sources:

(2024, September 10). European Respiratory Society. Drug treatment shows promise for dangerous snoring condition, obstructive sleep apnea. [News release]. https://www.ersnet.org/news-and-features/news/drug-treatment-shows-promise-for-dangerous-snoring-condition-obstructive-sleep-apnoea/

Hedner, J., et al. A randomized, double-blind, placebo controlled, dose-finding trial of sulthiame in obstructive sleep apnea. Abstract #OA5433. Presented at: European Respiratory Society Congress, September 7-11, 2024; Vienna, Austria. https://ers.app.box.com/s/6ziju4gpz0w19qcpnfqhk4vni7dri5ap