Data on Upper Airway Stimulation Therapy Show High Success Rates for Obstructive Sleep Apnea Patients

by Linda Kossoff •

What does a 2020 update of data from the Adherence and Outcome of Upper Airway Stimulation (UAS) for the Obstructive Sleep Apnea (OSA) International Registry (ADHERE) show regarding patient outcome, including analyses grouped by body mass index (BMI) and therapy discomfort?

BOTTOM LINE

This interval update from the ADHERE registry outcomes demonstrates efficacy, safety, and high adherence rates for UAS therapy, including BMI32 and BMI35 patient groups.

BACKGROUND: UAS therapy is an established therapy for positive airway pressure- intolerant patients. The ADHERE registry contains data from patients treated with UAS. Since its last publication of data, the number of patients in the ADHERE registry has almost doubled.

STUDY DESIGN: Prospective observational study.

SETTING: Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medicine/New York Presbyterian Hospital, New York, N.Y.

SYNOPSIS: Researchers identified 1,849 patients enrolled in ADHERE from Oct. 19, 2016, to March 13, 2020. Prevalent comorbidities included hypertension (46.8%), depression (23%), and diabetes (13.5%). Of all patients, 782 reached eligibility to complete a final follow-up visit and had reported apnea-hypopnea index (AHI), Epworth sleepiness scale (ESS), and/or therapy use. Final visit results showed mean therapy usage at 5.6 + 2.2 hrs./day and a median in AHI decrease from 33.0 to 9.9 events/hr. Subjective symptom improvement occurred with therapy use (median change 11.0 to 6.0). Approximately 19% of patients with follow- up data reported therapy-related discomfort, including stimulation-associated tongue abrasions and insomnia/ arousals. A total of 2.3% of subjects reported serious adverse events. Clinician assessment at final visit indicated improvement in 91% of subjects; 92% said they would choose UAS therapy again. A subanalysis of BMI32 and BMI35 groups showed decreases in OSA severity of 56% to 11% and 61% to 13%, respectively. Both groups reported normalization of ESS scores. Study limitations included inability to present final visit data for every enrolled ADHERE patient.

CITATION: Suurna MV, Steffen A, Boon M, et al. Impact of body mass index and discomfort on upper airway stimulation: ADHERE registry 2020 update. Laryngoscope. 2021;131:2616-2624.