Tirzepatide Cuts Time to Glycemic Targets by 4-12 Weeks vs Other Diabetes Therapies

Adie Viljoen, MD

A new analysis of data from the SURPASS program suggests use of tirzepatide (Mounjaro) could help people with diabetes reach glycemic targets in a fraction of the time as other medications.

Results of the analysis, which were presented at the European Association for the Study of Diabetes (EASD) Annual Meeting, indicate a weekly injection of tirzepatide helped adults with type 2 diabetes reach glycemic targets 4-12 weeks sooner than those receiving semaglutide 1 mg and long-acting insulin degludec.

“Tirzepatide is unique because it mimics two natural insulin-releasing and appetite-suppressing hormones in one injection”, said lead investigator Adie Viljoen, MD, a consultant metabolic physician and chemical pathologist from the East and North Hertfordshire NHS Trust in the United Kingdom, in a statement. “The speed we are seeing in glucose-lowering and weight loss is beyond anything else we have available right now and it may put adults with type 2 diabetes in a better position for preventing long-term complications. But it is important to remember that these medications should be used in addition to diet and exercise.”

With approval of Eli Lilly’s novel dual GIP/GLP-1, which occurred in May 2022, based on the results of the SURPASS program, multiple analyses have been conducted since the initial data release providing further insight into the effects of tirzepatide at different dosages and against different comparators. Available in US pharmacies beginning in June 2022, the agent has been embraced as a potential paradigm-shifting therapy with significant benefits on both diabetes and obesity. In the current study, which was an exploratory preplanned analysis, investigators leveraged data from the SURPASS-2 and -3 trials to assess time to achieve glycemic targets. This was assessed using the Kaplan Meier method and hazard ratios were calculated using Cox proportional hazards model.

In the overall SURPASS-2 trial, use of tirzepatide was compared against use of semaglutide 1.0 mg. Results of the study suggested use of tirzepatide was associated with greater improvements in HbA1cfrom baseline and proportion of people reaching HbA1c goals at 40 weeks. In the SURPASS-3 trial, use of tirzepatide was compared against titrated insulin degludec. Results of the study indicated use of tirzepatide was associated with greater improvements in HbA1c change from baseline and the proportion of patients reaching HbA1c at 52 weeks.

In the present analyses, initial results indicated use of tirzepatide was associated with a significantly faster time to reach HbA1c levels of 7% or lower and 6.5% or lower. The median time to achieve an HbA1c of 7% or below was 8.1 weeks across all tirzepatide doses compared with 12 weeks for semaglutide and 12.1 weeks for titrated insulin degludec. The median time to achieve an HbA1c of 6.5% or below was 12.1 weeks across all tirzepatide doses, 15.7 weeks with semaglutide 1.0 mg, and 24.1 weeks with titrated insulin degludec. In analyses pertaining to weight loss, results indicated tirzepatide was associated with a faster time to achieve 5% change in body weight than semaglutide 1.0, with those receiving tirzepatide achieving this at a median of 12 weeks when using tirzepatide at 10 or 15 mg compared to 24 weeks with semaglutide.

“Even a modest weight loss of 5% of initial body weight is associated with clinically significant improvements in weight-related health issues for many individuals”, Viljoen added in the aforementioned statement. “For people with type 2 diabetes to be able to achieve these improvements in health in around half the time is pretty incredible.”

This study, “Patients with type 2 diabetes reach glycaemic targets faster with tirzepatide compared to semaglutide and titrated insulin degludec,” was presented at EASD.