A Phase III, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Study to Evaluate the Efficacy and Safety of HDM1005 Injection in Subjects With Obstructive Sleep Apnea (OSA) and Obesity Receiving Positive Airway Pressure (PAP) Therapy

Inclusion Criteria:

• Age between 18 and 75 years, male or female, at the time of signing the informed consent form.
• BMI ≥ 28.0 kg/m² at both screening and randomization.
• A self-reported change in body weight no more than 5% within 90 days before screening.
• Subject has been diagnosed with obstructive sleep apnea (OSA) according to the International Classification of Sleep Disorders, 3rd Edition (ICSD-3) criteria prior to screening, and has a centrally assessed apnea-hypopnea index (AHI) ≥15 events/hour on polysomnography (PSG) at screening.
• ≥3 months of PAP therapy pre-screening with planned continuation; willingness to pause PAP ≥1 week before each PSG.

Exclusion Criteria:

• History of any type of diabetes mellitus (history of gestational diabetes is permitted).
• Have obesity induced by other endocrinologic disorders or by other medicine.
• History of thyroid C-cell carcinoma, multiple endocrine neoplasia type 2 (MEN2) or relevant family history.
• Diagnosis of central or mixed sleep apnea or Cheyne-Stokes respiration.
• Respiratory or neuromuscular diseases judged by the investigator to potentially interfere with trial results.
• Clinical abnormalities or diseases related to insomnia or excessive sleepiness (excluding OSA).
• Uncontrolled hypertension prior to screening, defined as: systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 100 mmHg (stable for 1 month if using antihypertensive drugs).
• History of malignancy (except cured basal cell carcinoma) in the past 5 years or at the time of screening.
• History of severe cardiovascular or cerebrovascular diseases within the past six months.
• The subject has any other factors that may affect the efficacy or safety evaluation of this study, and is not suitable for participation in this study in the opinion of the investigator.