Adults with type 2 diabetes reach HbA1c target faster with tirzepatide than semaglutide
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Adults with type 2 diabetes assigned tirzepatide achieved glycemic targets in a shorter time than those taking 1 mg semaglutide or titrated insulin degludec, according to an analysis of SURPASS-2 and SURPASS-3 data.
In findings presented at the European Association for the Study of Diabetes annual meeting, tirzepatide (Mounjaro, Eli Lilly) was superior to semaglutide (Ozempic, Novo Nordisk) and titrated insulin degludec (Tresiba, Novo Nordisk) in median time to reach target HbA1c of 7% and 6.5%, and adults in SURPASS-2 taking any dose of tirzepatide achieved a body weight loss of 5% or greater in faster time than those randomly assigned semaglutide.
“Tirzepatide is unique because it mimics two natural insulin-releasing and appetite-suppressing hormones in one injection,” Adie Viljoen, MBChB, Mmed, FCPath, FRCPath, MBA, a consultant metabolic physician and chemical pathologist at the East and North Hertfordshire NHS Trust, U.K., said in a press release. “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.”
Viljoen and colleagues conducted a preplanned exploratory analysis of the SURPASS-2 and SURPASS-3 trials. In SURPASS-2, people with type 2 diabetes were randomly assigned 5 mg, 10 mg or 15 mg tirzepatide — or 1 mg semaglutide — for 40 weeks, whereas in SURPASS-3, participants were randomly assigned tirzepatide or titrated insulin degludec for 52 weeks. In both trials, therapy was given alongside a stable dose of 1,500 mg metformin daily. In both trials, those using tirzepatide had greater HbA1c and body weight reductions than those using semaglutide or titrated insulin degludec. In the exploratory analysis, researchers analyzed the time to achieve HbA1c targets of 7% and 6.5%, and a body weight loss target of 5%.
In SURPASS-2, the median time to reach an HbA1c of less than 7% was 8.1 weeks for all adults taking tirzepatide, regardless of dose, compared with 12 weeks for the semaglutide group. Median time to reach an HbA1c of 6.5% was also lower with tirzepatide compared with semaglutide (12.1 weeks vs. 15.7 weeks). Adults taking 10 mg or 15 mg tirzepatide achieved a body weight loss of 5% 12 weeks sooner than those taking semaglutide, and patients receiving 5 mg tirzepatide achieved 5% body weight loss 8 weeks sooner than the semaglutide group.
“Even more stringent weight-loss targets of 15% are leaning toward the superiority of tirzepatide,” Viljoen said during the presentation.
In SURPASS-3, those taking tirzepatide achieved an HbA1c of less than 7% in a median of 8.1 weeks compared with 12.1 weeks in those taking insulin degludec. The median time to reach an HbA1c of 6.5% or less was 12.1 weeks in the tirzepatide group compared with 24.1 weeks with insulin degludec.
The risk for hypoglycemia was similar between the tirzepatide and semaglutide groups in SURPASS-2 and lower in adults taking tirzepatide compared with insulin degludec in SURPASS-3. The safety profile for tirzepatide was similar to other GLP-1 receptor agonists.
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Viljoen A, et al. SO 591. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 19-23, 2022; Stockholm (hybrid meeting).
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