Trial reportRespirology (Carlton, Vic.)2022
Atomoxetine and fesoterodine combination improves obstructive sleep apnoea severity in patients with milder upper airway collapsibility.
Trial report in Respirology (Carlton, Vic.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Are noradrenergics combined with antimuscarinics the future pharmacologic treatment for obstructive sleep apnea? A systematic review and meta-analysis of randomized controlled trials.Sleep & breathing = Schlaf & Atmung · 2024Pooled it
- The Hypoxic Burden, Clinical Implication of a New Biomarker in the Cardiovascular Management of Sleep Apnea Patients: A Systematic Review.Reviews in cardiovascular medicine · 2024Pooled it
- Acetazolamide to prevent ventilatory drive withdrawal in REM sleep apnoea: a randomised controlled trial.Thorax · 2026Trial
- Effect of viloxazine and trazodone in obstructive sleep apnoea: a randomised, placebo-controlled, cross-over study.Thorax · 2025Trial
- Effects of the Combination of Pimavanserin and Atomoxetine on OSA Severity: A Randomized Crossover Trial.Chest · 2025Trial
- Precision Pharmacotherapy for Obstructive Sleep Apnea: Matching Targeted Drugs to Patient Endophenotypes.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Targeting Hypoglossal Neurobiology in the Treatment of Obstructive Sleep Apnea: The Emergence of Aroxybutynin-Atomoxetine (AD109).Brain sciences · 2026Article
- Mechanisms of upper airway muscle control in sleep reveal therapeutic targets for obstructive sleep apnea.American journal of respiratory cell and molecular biology · 2026Review
- Endophenotypes of OSA that are responsive to pharmacological agents: a narrative review of trazodone and atomoxetine.Sleep & breathing = Schlaf & Atmung · 2026Review
- Review
- Diagnosis and Management of Overlap Syndrome (COPD-OSA): Evidence, Challenges and Prospects.Nature and science of sleep · 2026Review
- The Emerging Role of Pharmacotherapy in Obstructive Sleep Apnea.Journal of otorhinolaryngology, hearing and balance medicine · 2024Article
- Combination of Aroxybutynin and Atomoxetine in Obstructive Sleep Apnea: Is the Effect of One Plus One Greater than Two?American journal of respiratory and critical care medicine · 2024Article
- Pharmacological interventions for the treatment of obstructive sleep apnea syndrome.Frontiers in medicine · 2024Article
- Article
- Development of a combination of noradrenergic and antimuscarinic drugs for the treatment of obstructive sleep apnea: Challenges and progress.Frontiers in sleep · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 2 countries.
Funding
Abstract
BACKGROUND AND
objectiveThe combination of the noradrenergic atomoxetine plus the anti-muscarinic oxybutynin acutely increased genioglossus activity and reduced obstructive sleep apnoea (OSA) severity. However, oxybutynin has shorter half-life than atomoxetine and side effects that might discourage long-term usage. Accordingly, we aimed to test the combination of atomoxetine and fesoterodine (Ato-Feso), a newer anti-muscarinic with extended release formulation, on OSA severity and endotypes.
methodsTwelve subjects with OSA underwent a randomized, double-blind, crossover trial comparing one night of atomoxetine plus fesoterodine (80-4 mg) to placebo. Parameters of OSA severity (e.g., apnoea-hypopnoea index [AHI], nadir oxygen desaturation and hypoxic burden) were calculated from two clinical, in-lab polysomnographic studies. OSA endotypes (including collapsibility per V
resultsCompared to placebo, Ato-Feso did not reduce the AHI (34.2 ± 19.1 vs. 30.1 ± 28.2 events/h, p = 0.493), but reduced the apnoea index (12.9 [28.8] vs. 1.8 [9.1] events/h, median [interquartile range], p = 0.027) and increased nadir desaturation (76.8 [8.0] vs. 82.2 [8.8] %, p = 0.003); a non-significant trend for improved hypoxic burden was observed (52.4 [50.5] vs. 29.7 [78.9] %min/h, p = 0.093). Ato-Feso lowered collapsibility (raised V
conclusionWhile inefficacious in unselected patients, Ato-Feso administered for one night suppressed OSA in patients with milder collapsibility. Ato-Feso may hold some promise as an alternative OSA treatment in certain subgroups of individuals.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.