EFFECTIVENESS OF ZONISAMIDE IN REDUCING SLEEP-DISORDERED BREATHING IN OVERWEIGHT AND OBESE PATIENTS WITH MODERATE-TO-SEVERE OBSTRUCTIVE SLEEP APNOEA: A RANDOMIZED CONTROLLED TRIAL

Abstract

The inhibitors of carbonic anhydrase minimise the apnoeic events of the sleep related breathing disturbances disease. There is also the prevention of weight loss as the drug that causes weight loss in the overweight person; the carbons anhydrase which is inhibited by zonisamide. The study was conducted in order to find out in quantitative way relative role of these two features that can be used to reduce obstructive sleep apnoea (OSA). A standard care that was continuous positive airway pressure or CPAP was the tool used to compare the methods. The people on whom this trial was conducted were moderate plus severe OSA conditioned people with a body mass index (BMI) of 27-35 (kg/m2) and were randomly assigned the zonisamide, placebo or the CPAP over a period of 4 weeks. The second (20 weeks) period resulted in comparing the CPAP and zonisamide in the sense of open-label extension study. There were polysomnography, laboratory testing and symptom check. As of the 4th week, zonisamide exhibited even greater decrease in apnoea/hypopnoea index (AHI) by 33 39 % and oxygen desaturation index by 28 31 %. After 24 weeks follow up period, averagely the AHI decreased by 13 percent and 61 percent when using zonisamide and CPAP respectively ( p= 0.001). Thaughts there was little variance in body weight in 4 weeks after which the weight decreased after zonisamide application and was increased after application of CPAP (-2.713.0 vs. 2.320.0, p0.001). The level of Bicarbonate decreased after 4 weeks and 24 weeks with Zonisamide. Trends were demonstrated to be on the adverse side in zonisamide.  Zonisamide also reduced OSA despite no weight loss and this can be explained by the aspect that zonisamide has the properties of carbonic anhydrase inhibition. Nonetheless, its effect was not as massive as the effect of CPAP on it.