The new drug that may offer an alternative to the existing treatment for obstructive apnea

The first drug Atomoxetine (atomoxetine), originally intended for the treatment of attention deficit hyperactivity disorder (ADHD), and is marketed in Israel under the trade names Atomic and Strattera. Atomoxetine inhibits the reabsorption of the neurotransmitter norepinephrine in synapses – the meeting points between nerve cells. The delay causes the neurotransmitter to continue activating the muscles of the throat and pharynx and, among other things, the muscles that pull the tongue forward and prevent it from falling back, which contributes to greater stability of the airways during sleep. However, atomoxetine may have a negative effect on sleep: patients take longer to fall asleep, and the quality of their sleep decreases.

dictation Originally published on the Davidson Institute for Science Education website

The new treatment combines atomoxetine with a derivative of Oxybutynin (oxybutinin), an old medicine for the treatment of irritable bladder. The drug blocks receptors for the neurotransmitter Acetylcholine in the nerve cells, thus reducing excess nerve activity in the areas of the brain that are responsible for tongue movements. in research In rats, it was found that oxybutynin stabilizes the activity pattern of the nerve cells that activate the tongue muscles, thus preventing abnormal oscillations or vibrations, which could damage the stability of the air passage.

For the new treatment, the company produced an experimental version of oxybutynin called Aroxybutynin (aroxybutinin), which allows for improved oral absorption and is expected to cause fewer side effects. The researchers estimate that the combination of the drugs creates a synergy: atomoxetine strengthens the tension of the muscles that keep the airways open, while eroxibutinin helps them work smoothly and stably and without “jumps”, which will allow continuous and continuous passage of air.

A clinical trial showed that the combination of the two drugs reduces the number of sleep interruptions, that is, reduces the severity of the phenomenon, in 51 percent of the patients. 22 percent of them even reached a state of less than five breath pauses per hour – which is defined as a normal state. The company plans to submit to the FDA a new approval request for the drug treatment by the beginning of 2026, alongside the publication of the full results in a scientific article and conference, and continues In another clinical trial for a year.

The main advantage of the new drug treatment over the existing cPAP device treatment is that it will certainly be easier for patients to persist in taking oral drug therapy compared to being connected to the device all night.

This is not the only drug that has been studied in recent years for obstructive sleep apnea. medicine called tirzepatide For type 2 diabetes and weight reduction, approved in the United States under the name Zepbound for patients with obesity-related apnea. In contrast, the drug treatment AD109 directly targets the muscles of the airways and is also intended for patients who are not suitable for treatment based on weight loss. It is important to note that the drug has not yet been approved, and that long-term follow-up, of months and even years, is required in order to assess side effects, risks and benefits for patients. However, the results raise hope that this development could offer an alternative to the existing treatment and allow many to sleep better quality sleep, be less tired and avoid a variety of health problems that endanger those suffering from sleep apnea.