Lilly Weight-Loss Drugs Show Promise Against Sleep Apnea and Knee Arthritis Pain in New Studies

Eli Lilly says two of its newer weight-loss medicines may help with more than the bathroom scale. In studies released this week, the company's daily pill Foundayo eased the breathing interruptions of obstructive sleep apnea, and an experimental weekly shot called retatrutide sharply reduced knee pain in people with osteoarthritis, Time reported ^[1].

For readers who wrestle with a CPAP mask or stiff knees, the news deserves a close look. But the medicines are costly, one is unapproved, and regulators just announced a new warning for the class.

What the Sleep Apnea Studies Found

Foundayo, the brand name for orforglipron, is a once-daily GLP-1 pill the Food and Drug Administration approved in April for chronic weight management ^[3]. Lilly tested it in two year-long Phase 3 trials, called ATTAIN-OSA, in overweight or obese adults with moderate-to-severe sleep apnea ^[2]. One study enrolled 363 people who could not or would not use a positive airway pressure machine, commonly called a CPAP; the other enrolled 349 people who kept using their machines ^[2].

Among patients without a machine, Foundayo cut breathing interruptions by about 44 percent from a starting average of roughly 51 events an hour, compared with about 6 percent on placebo, according to the company ^[2]. Patients using machines saw a reduction of about 27.5 percent ^[2]. By year's end, 31.5 percent of the first group and 19.6 percent of the second had reached remission or mild disease, and both groups lost about 11 percent of their body weight, or roughly 28 pounds ^[2].

The results were presented at the American Heart Association's Scientific Sessions in Chicago and published in JAMA ^[3]. Michael Grandner, who directs the sleep and health research program at the University of Arizona, noted that no oral sleep apnea treatment exists today and called a pill potentially "a game changer" ^[3]. Dr. Ashish Sarraju of the Cleveland Clinic wrote that the pill could reach patients who cannot get or tolerate Zepbound, Lilly's injectable approved for sleep apnea in 2024, or who would rather avoid needles ^[3]. Lilly plans to ask the FDA by the end of this year to approve Foundayo for sleep apnea ^[2].

Knee Pain Relief From an Experimental Shot

The arthritis results involve retatrutide, an injection still in development that targets three hormones, compared with one for Foundayo and two for Zepbound ^[1]. In two Phase 3 trials with more than 1,000 combined participants who had obesity and knee osteoarthritis, patients on the highest dose lost about a quarter of their body weight on average, News-Medical reported ^[4]. In a pooled analysis, about two-thirds of those on retatrutide saw knee pain fall by at least half, compared with 38 percent on placebo ^[4].

The findings were presented Sunday at the American College of Rheumatology's annual meeting in Orlando and published in the New England Journal of Medicine ^[4]. Study author Dr. Thomas Schnitzer of Northwestern University said heavy weight loss gives patients a good chance at meaningful relief, mainly because the knee carries less load ^[4]. Lilly executive Ken Custer suggested the drugs may ease pain through effects "mediated by something other than weight loss," and the company is now testing retatrutide for chronic low back pain ^[1].

Cost, Coverage and Caution

Price remains a hurdle. On TrumpRx, a government website linking to cash discounts, Foundayo tops out at $349 a month, and cash prices for these drugs typically run from $149 to $699 a month, KFF Health News reported ^[5]. Since July 1, a temporary Medicare GLP-1 Bridge has let eligible Part D enrollees get Foundayo, Wegovy or a version of Zepbound for weight loss at a flat $50 monthly copay through 2027 ^[5]. Patients generally qualify with a body mass index of 35 or higher, or 27 or higher plus a condition such as heart disease or prediabetes ^[5]. But seniors taking a GLP-1 for sleep apnea stay in their regular Part D plan, where they may pay more, and KFF's Juliette Cubanski warned the Bridge is likely to add billions of dollars a year in Medicare spending ^[5].

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Side effects matter, too. In the sleep apnea trials, the most common problems were digestive, such as nausea and diarrhea, and about 12 percent of Foundayo patients not using a machine quit because of side effects, versus about 4 percent on placebo ^[2]. Separately, the FDA said this week it will add a warning to all GLP-1 labels about a rare optic nerve condition that can cause significant vision loss, found in roughly 6 of every 100,000 patients who took the drugs for at least a year, the Associated Press reported ^[6].

For older readers, a few facts stand out. Foundayo is approved only for weight management, not yet for sleep apnea, and retatrutide is not on the market ^[1]. Studies cited by KFF show many people regain weight after stopping these drugs, so they are best viewed as a long-term commitment ^[5]. The wise path is an honest conversation with a trusted physician about benefits, risks and cost, as part of good stewardship of the health God gives us. Lilly's sleep apnea filing, expected by year's end, is the next milestone to watch ^[2].