Tirzepatide for Reducing HbA1c and Body Weight in Type 2 Diabetes with Juan Frias, MD

What has been hailed by some endocrinologists as a revolutionary agent for type 2 diabetes management is showing promise against a staple in diabetes management in a recent phase 3 trial.

The trial looked at tirzepatide, a novel dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist, in 5 mg, 10 mg, and 15 mg doses and compared it against 1 mg semaglutide. Topline results of the trial, which were announced in a statement from Eli Lilly on March 4, suggest use of tirzepatide was associated with reductions in HbA1c ranging 2.09-2.46% and body weight from 7.8-12.4 kg, depending on dosage used.

SURPASS-2 was designed as a 40-week, randomized, open-label trial of 1879 adults with type 2 diabetes. The study cohort had a mean weight of 206.6 pounds at baseline and a mean HbA1c level of 8.28%. These patients were randomized in a 1:1:1:1 ratio to either 5 mg, 10 mg, or 15 mg tirzepatide or 1 mg semaglutide.

Upon analysis, the 5, 10, and 15 mg doses of tirzepatide were associated with mean HbA1c reductions of -2.09, -2.37, and -2.46%, respectively, compared to a mean reduction of -1.86% with semaglutide. Mean body weight reductions were -7.8, -10.3, and -12.4 kg with the 5, 10, and 15 mg doses, respectively, compared to -6.2 kg with semaglutide.

When assessing percentage of patients who reached a target HbA1c of 7% or less, investigators found more than 85% of patients receiving any dose of tirzepatide reached 7% compared to 81.1% of those receiving semaglutide. Of note, tirzepatide 15 mg was associated with greatest percentage of patients meeting an HbA1c of 7% at 92.2% of patients.

For more on the results of SURPASS-2 and what it tells us about use of tirzepatide, check out this interview with principal investigator Juan Frias, MD, medical director of the National Research Institute.