Retatrutide Once Weekly for Treatment of Obstructive Sleep Apnea

Original title: Retatrutide Once Weekly for Treatment of Obstructive Sleep Apnea.

Retatrutide, an investigational triple agonist of glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and glucagon receptors, may be useful for treating obstructive sleep apnea (OSA).

By Grunstein, Somers, Azarbarzin +10The New England journal of medicineOct 21, 2026

Score█████░░░░░5.1

Key numbers

95% confidence interval CI
95% CI
22.2% in TRIUMPH-1-OSA and

VerdictA leading story on any desk.

Read the original

Abstract

Background Retatrutide, an investigational triple agonist of glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and glucagon receptors, may be useful for treating obstructive sleep apnea (OSA). Methods In two phase 3, double-blind, randomized, placebo-controlled trials nested within larger basket trials of once-weekly subcutaneous retatrutide, we assigned adults with moderate-to-severe OSA and a body-mass index (the weight in kilograms divided by the square of the height in meters) of at least 27, without (TRIUMPH-1-OSA) or with (TRIUMPH-2-OSA) type 2 diabetes, to receive retatrutide (4, 9, or 12 mg) or placebo. The primary end point was the change in the apnea-hypopnea index (AHI, the average number of apneas and hypopneas per hour of sleep) at 80 weeks with 9 mg and 12 mg of retatrutide. For OSA-related end points, a hybrid-treatment estimand was applied, with a hypothetical strategy used for participants who had intercurrent events suggesting treatment failure and a treatment-policy strategy used elsewhere. We also report intention-to-treat (ITT) results. Results A total of 243 participants underwent randomization in TRIUMPH-1-OSA and 448 in TRIUMPH-2-OSA. The baseline mean AHI was 58.6 and 55.9 events per hour, respectively, and the mean body weight was 119.6 and 115.9 kg. At 80 weeks, the mean changes in the AHI (hybrid-treatment estimand) with retatrutide in TRIUMPH-1-OSA were -22.9 (4 mg), -34.3 (9 mg), and -31.7 (12 mg) events per hour, versus -9.9 with placebo (difference vs. placebo, -13.0 [95% confidence interval {CI}, -23.0 to -3.0], -24.4 [95% CI, -34.1 to -14.7], and -21.9 [95% CI, -32.2 to -11.5], respectively). The changes with retatrutide in TRIUMPH-2-OSA were -19.2 (4 mg), -24.7 (9 mg), and -25.4 (12 mg) events per hour, versus -10.3 with placebo (difference vs. placebo, -8.9 [95% CI, -15.9 to -2.0], -14.4 [95% CI, -21.6 to -7.2], and -15.1 [95% CI, -22.5 to -7.7]). For the ITT estimand, the corresponding differences from placebo were -13.2 (95% CI, -22.6 to -3.9), -24.7 (95% CI, -34.1 to -15.3), and -22.5 (95% CI, -31.9 to -13.1) in TRIUMPH-1-OSA and -8.8 (95% CI, -15.8 to -1.7), -13.9 (95% CI, -21.3 to -6.6), and -15.0 (95% CI, -22.5 to -7.4) in TRIUMPH-2-OSA. The mean percent change in body weight with retatrutide (key secondary end point) was -12.5 to -22.2% in TRIUMPH-1-OSA and -12.1 to -18.5% in TRIUMPH-2-OSA, versus -4.8% and -5.6% with placebo (treatment-regimen estimand). The most common adverse events were gastrointestinal. Conclusions In adults with OSA and obesity or overweight with or without type 2 diabetes, retatrutide resulted in significantly greater decreases in the AHI than placebo. (Funded by Eli Lilly; TRIUMPH-1 and -2 ClinicalTrials.gov numbers, NCT05929066 and NCT05929079.).

Ronald R Grunstein, Virend K Somers, Ali Azarbarzin, Atul Malhotra, Scott A Sands, Brendan P Lucey, Sheryl E Allen, Kathryn Giblin, Beverly L Falcon, So Young Park, Jitong Lou, Kathryn Krueger, TRIUMPH-1-OSA and TRIUMPH-2-OSA Investigators

The editor's rubric

Heuristic review

Leverage2 / 5: Reusable within one subfield (a technique, dataset, or protocol a few groups will adopt).; 10% of this desk’s rubric
Magnitude3 / 5: Large gain: roughly 2x, or a clear new state of the art on a hard, unsaturated problem.; 20% of this desk’s rubric
Evidence5 / 5: Definitive: phase 3 randomized evidence on hard endpoints, multi-lab replication, or community verification at scale.; 32% of this desk’s rubric
Novelty3 / 5: A genuinely new approach to an open problem.; 8% of this desk’s rubric
Trajectory2 / 5: Some room to improve with obvious engineering.; 5% of this desk’s rubric
Stakes3 / 5: Meaningful benefit to many people within a few years.; 25% of this desk’s rubric

Dimension	Level	Weight	What that level means
Leverage	██░░░ 2	10%	Reusable within one subfield (a technique, dataset, or protocol a few groups will adopt).
Magnitude	███░░ 3	20%	Large gain: roughly 2x, or a clear new state of the art on a hard, unsaturated problem.
Evidence	█████ 5	32%	Definitive: phase 3 randomized evidence on hard endpoints, multi-lab replication, or community verification at scale.
Novelty	███░░ 3	8%	A genuinely new approach to an open problem.
Trajectory	██░░░ 2	5%	Some room to improve with obvious engineering.
Stakes	███░░ 3	25%	Meaningful benefit to many people within a few years.

Editor’s rationale

Heuristic triage from title and abstract text only, not a reading of the paper. Cues found: design (randomized, blinded, placebo-controlled); verification (confidence interval); stakes (major disease, prevention or cure).

How the score was computed

rank-2026-10-18

Score█████░░░░░5.1

Score = 10 × (80% × adjusted merit / 10 + 10% × attention + 10% × freshness)

Desks place stronger verdicts first, then use this score to order work within the same verdict.

Merit: 7.0 / 10; Weighted rubric, evidence-gated.
Adjusted merit: 5.4 / 10; Shrunk toward the desk prior by editor confidence (46%).
Attention: 0%; Citations, upvotes, points, mentions.
Freshness: 80%; Half-life decay since publication.

Citations0 (reference 20, via openalex, Oct 24, 2026, 06:17 UTC)

The record

Reviewed by heuristic-v7 on Oct 24, 2026, 06:17 UTC. Paper type: clinical.
Categories: Journal Article
LEAD, No.1 in the Front page edition of October 24, 2026.
LEAD, No.1 in the Medicine edition of October 24, 2026.