RECENT analysis from the SURPASS-4 trial, presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Madrid, Spain, has revealed crucial factors influencing the long-term effectiveness of tirzepatide for Type 2 diabetes (T2D). The research highlights how specific predictors can guide treatment strategies to enhance both blood glucose control and weight loss outcomes.
The SURPASS-4 trial initially demonstrated that tirzepatide, a dual glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptor agonist, outperforms insulin glargine in managing blood glucose and supporting weight loss. The latest analysis builds on these findings by identifying key factors associated with sustained success.
The study found that up to 83% of adults who received tirzepatide for over a year maintained their blood glucose targets or achieved significant weight loss for an additional year. Crucial predictors for maintaining blood glucose control include higher tirzepatide doses, better beta-cell function, greater weight loss, and a significant reduction in low-density lipoprotein cholesterol (LDL-C) during the first year of therapy.
Notably, individuals on the higher 15 mg dose of tirzepatide were 39% more likely to sustain blood glucose control compared to those on the lower 5 mg dose. Additionally, women were found to be 48% more likely than men to maintain glycaemic control over the long term.
In terms of weight management, achieving and sustaining a clinically meaningful weight loss (defined as at least 10% of initial body weight) was also strongly linked to higher tirzepatide doses and being female. Key predictors of sustained weight loss included a greater decrease in LDL-C and lower baseline levels of HbA1c, triglycerides, and estimated glomerular filtration rate. Interestingly, no single predictor was found to be clinically significant for sustained weight loss beyond these factors.
The research underlines the need for tailored treatment approaches in managing T2D, emphasising that both biological and demographic factors play a critical role in treatment outcomes. Lead author Steven Kahn, University of Washington, Seattle, USA, noted: “These results are very encouraging, and one hopes we will gain more insight from upcoming studies such as SURPASS-CVOT that includes a larger number of participants followed for longer.”
Katie Wright, EMJ
Reference
Kahn SE et al. Predictors of achieving and sustaining glycaemic control and weight loss with tirzepatide in individuals with type 2 diabetes and increased cardiovascular risk (SURPASS-4). Abstract 757. EASD Annual Meeting, 9–13 September, 2024.
