Tirzepatide Reduces Time to HbA1c Targets by Up to 3 Months vs. Semaglutide, Insulin Degludec

Tirzepatide (Mounjaro, Eli Lilly) was associated with faster achievement of glycemic goals and weight loss goals in patients with type 2 diabetes (T2D) than either semaglutide or insulin titrated degludec (iDeg) in a new analysis of data from the landmark transcend Clinical trial program.

The results, which were presented as an abstract at the annual meeting of the European Association for the Study of Diabetes (EASD), showed that adults with T2D treated with dual GIP/GLP-1 mimetics once weekly reached glycemic goals 4 to 12 weeks earlier. of those goals. Receive semaglutide 1 mg and a long-acting iDeg. Moreover, according to the study abstract, patients treated with tirzepatide lost 5% of their baseline body weight much faster than those treated with semaglutide. The abstract was simultaneously published in the journal diabetes.

“Tirzepatide is unique in that it mimics two natural hormones that release insulin and suppress appetite in one injection,” said lead researcher Adie Viljoen, MD, a consultant metabolic and chemical pathologist from the East and North Hertfordshire Trust in the United Kingdom. in EASD statement. “The speed we observe in lowering glucose and losing weight is beyond anything else we currently have and may put adults with type 2 diabetes in a better position to prevent long-term complications.” Keep in mind, Viljoen added, that medications of this type do not work alone and are indicated for use as an aid to diet and exercise.

US Food and Drug Administration Approved tirzepatide In May 2022 for the treatment of T2D based on 5 studies including Lilly’s Phase 3 SURPASS clinical trial program. The SURPASS trials compared the glucose-lowering efficacy of tirzepatide with other classes of antihyperglycemic drugs, at different doses as monotherapy and in combination with comparison agents. The dual incretin receptor agonist demonstrated superior HbA1c reduction in all trials.

The new study, a pre-planned exploratory analysis, evaluated data from the SURPASS-2 and -3 trials (see sidebar) to assess time to achieve glycemic goals.

In this analysis, Viljoen and colleagues found that patients treated with tirzepatide reached HbA1c levels both 7% and 6.5 significantly faster than those treated with either semaglutide or iDeg.

They reported that the median time to achieve HbA1c ≤7% was 8.1 weeks across all tirzepatide doses compared to 12 weeks for semaglutide and 12.1 weeks for titrated insulin degludec.

The time to HbA1c of 6.5% was 12.1 weeks for all participants treated with tirzepatide compared with 15.7 weeks for those taking semaglutide and 24.1 weeks for patients treated with iDeg.

The researchers also found that tirzepatide outperformed semaglutide 1.0 mg in time to achieve a 5% weight loss, with the 10 and 15 mg tirzepatide treatment groups reaching the target at an average of 12 weeks and semaglutide-treated patients at 24 weeks.

“Even a small weight loss of 5% of initial body weight is associated with clinically significant improvements in weight-related health problems for many individuals,” Viljoen added in the association’s statement. “For people with type 2 diabetes, their ability to achieve these improvements in health in about half the time is incredible.”

Gastrointestinal adverse events were reported as mild to moderate in patients taking tirzepatide including nausea, vomiting, and diarrhea and were frequently seen in the period of dose escalation with decrease over time.

Viljoen A, Pantalone KM, Galindo RJ, et al. Patients with type 2 diabetes reach glycemic goals faster with tirzepatide than with semaglutide and titrated insulin degludec. The abstract was presented at the 58th meeting of the European Association for the Study of Diabetes. from 19 to 23 September 2022; Stockholm, Sweden. Abstract 591