打呼噜 z-bio 2025-07-07 3122

　　On July 3, 2025, the China National Medical Products Administration (NMPA) officially approved Eli Lilly's terpopeptide (trade name: Mufengda ®) for the treatment of adult obesity combined with moderate to severe obstructive sleep apnea (OSA).

　　As China's first and only approved OSA treatment drug, tilpeptide has brought a fundamental change from "symptom control" to "cause treatment" to nearly 200 million Chinese OSA patients by targeting the core cause of obesity.

　　Underrated "sleep killer"

　　Obstructive sleep apnea (OSA) is characterized by repeated breathing interruptions at night, accompanied by a decrease in blood oxygen and micro-awakening, resulting in a surge in the risk of daytime sleepiness, fatigue and cardiovascular disease - including a 4.33-fold increase in stroke risk and a 1.98-fold increase in all-cause mortality rate (the mortality rate of severe patients reaches 3.8 times for the general population). The traffic accidents and metabolic disorders caused by it cause more than 100 billion yuan in economic losses to China every year.

　　According to epidemiological data, the total prevalence of OSA in my country is as high as 23.6% (nearly 200 million people), and moderate to severe patients account for 8.8% (about 65.5 million). What’s more serious is that 41% of moderate to severe OSA patients are obese, and obesity itself is the core cause of OSA. Its prevalence is far beyond the global average and is on a rapid upward trend. It is expected that the total number of patients will exceed 200 million in 2026.

　　The top ten countries with the largest number of individuals with obstructive sleep apnea

　　However, due to insufficient public awareness, the diagnosis rate of OSA in my country is less than 15%, and 85% of patients have not received effective intervention before serious complications occur. Previously, the symptoms could only be relieved through psychiatric drugs such as ventilator (CPAP) or modafinil, but the compliance of ventilator was less than 30%. Modafinil was listed as a Class I psychiatric control drug due to its addictive nature, and its clinical application was limited.

　　The symptom disappearance rate exceeds 50%, and the weight loss effect reaches 20%.

　　The SURMOUNT-OSA Phase III trial is the largest global study in the field of OSA drug treatment, covering 469 patients in 9 countries including China, the United States, and Japan. Data showed that the number of hourly respiratory interruptions (AHI) in the tilpope alone group was significantly reduced by 27 times, the complete symptom remission rate was 43%, and the average weight loss was 18.1%, which solved the vicious cycle of obesity and OSA at the root.

　　When used in combination with the ventilator, the AHI reduction increased to 30 beats/hour, the remission rate reached 52%, and the weight loss effect reached 20.1%, both significantly better than the placebo group.

　　Dr. Wang Li, senior vice president of Eli Lilly, pointed out: "For the first time, tilpope peptide solves OSA from the level of obesity, and the disappearance of symptoms in half of the patients marks a revolutionary breakthrough in the controllability of the disease."

　　Dual targets to directly hit the causes of obesity:

　　Telpopeptide achieves the dual role of "inhibition of appetite + regulating energy metabolism" by simultaneously activating GLP-1 and GIP (glucose-dependent insulin polypeptide) receptors. GLP-1 receptor activation can delay gastric emptying and reduce food intake, while GIP receptor activation enhances insulin secretion and promotes fat decomposition. The synergistic effect of the two not only has a significant weight loss effect, but also improves adipose tissue metabolism and inflammatory state.

　　Compared with the single-target drug semegglutide, the weight loss effect of tilpope in head-to-head trials was 47% (20.2% vs 13.7%), and the severe remission rate doubled, fully demonstrating the advantages of the dual-target mechanism.

　　Experts call for: Improve screening rate and standardize drug use management

　　Professor Xiao Yi of Peking Union Medical College Hospital emphasized: "The diagnosis rate of OSA is less than 1%, and it is urgent to strengthen public education promotion screening. Telpopeptide provides new options for patients with obesity, but it needs to strictly follow prescription norms."

　　Clinical trials showed that 39.7% of patients in the tilpopeptide group experienced nausea, 31% experienced diarrhea, and 10.5% stopped the drug due to adverse reactions. What is more worth noting is that long-term use of GLP-1 drugs may increase the risk of thyroid C cell tumors (animal trial prompts), while monitoring data for complications such as pancreatitis and gallstones still require time to accumulate.

　　Professor Guo Lixin from Beijing Hospital said that weight loss is to treat OSA - this concept has been verified by the efficacy of tilpope peptide. In the future, it is necessary to explore its potential in the fields of cardiovascular protection and fatty liver improvement.　

　　The annual fee of 100,000 yuan has not been included in the medical insurance, and the expansion of indications has accelerated

　　Currently, tielpore peptide has four specifications (2.5mg/5mg/7.5mg/10mg) in China. The price of e-commerce platforms is about 2,249-4,090 yuan per box (4 packs). Based on the 4 pieces per month, the annual treatment cost is nearly 100,000 yuan. The National Medical Insurance clearly excludes weight loss drugs from the reimbursement range. Only the indications for diabetes can be paid for by medical insurance.

　　This approval is the third indication for terpopeptide in China, which has previously covered type 2 diabetes (May 2024) and obesity (July 2024). Eli Lilly China General Manager De Helan said that the drug will help the "Healthy China 2030" strategy and promote sleep health management into a new stage of etiology treatment.

　　Eli Lilly is planning to expand its indications to non-alcoholic steatohepatitis (NASH), Alzheimer's disease, etc., targeting the ultimate goal of "wide-region treatment of metabolic syndrome".

　　At the industrial level, Eli Lilly established the market leadership of GLP-1 with the "one drug, multiple indications" strategy, and also forced companies such as Novo Nordisk and Pfizer to accelerate the research and development of multi-target drugs. In the future, with the launch of new drugs such as oral GLP-1 and three-target agonists, the OSA treatment field will usher in more intense competition, and the ultimate benefit will still be patients suffering from related diseases.