Effects of the Combination of Atomoxetine and Oxybutynin on Obstructive Sleep Apnea Endotypic Traits.

Effects of the Combination of Atomoxetine and Oxybutynin on Obstructive Sleep Apnea Endotypic Traits. Chest. 2020 Jan 29;: Authors: Taranto-Montemurro L, Messineo L, Azarbarzin A, Vena D, Hess L, Calianese N, White DP, Wellman A, Sands S Abstract BACKGROUND: We recently showed that the administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) before sleep greatly reduced obstructive sleep apnea (OSA) severity, likely by increasing upper airway dilator muscle activity during sleep. RESEARCH QUESTION: In patients with OSA who performed the ato-oxy trial with an esophageal pressure catheter to estimate ventilatory drive, we measured the effect of the drug combination (n=17) and of the single drugs (n=6) on the endotypic traits (listed below) over a 1-night administration and compared it to placebo. We also tested if specific traits were predictors of complete response to treatment (reduction in AHI >50% and <10 events/h). STUDY DESIGN AND METHODS: The study was a double blinded randomized, placebo-controlled trial. The arousal threshold, collapsibility (ventilation at eupnoeic drive, Vpassive), ventilation at arousal threshold (Vactive) and loop gain (LG1), were calculated during spontaneous breathing during sleep. Muscle compensation (upper airway response) was calculated as a function of Vactive adjusted for Vpassive. RESULTS: Compared to placebo,...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research