Time spent in glycaemic control with sustained body weight reduction with tirzepatide: A post hoc analysis of the SURPASS clinical trial programme

🥉 Top 5% JournalMar 14, 2025Diabetes, obesity & metabolism

Time with controlled blood sugar during lasting weight loss with tirzepatide: A detailed analysis of the SURPASS trials

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Abstract

Participants treated with tirzepatide spent 80% of the treatment duration with HbA1c levels below 7.0% compared to 70% for semaglutide and 0% for placebo.

Median time spent with HbA1c < 7.0% was significantly higher for tirzepatide than for active comparators in both 40-week and 52-week studies.
Tirzepatide showed generally similar time spent in glycaemic control across different dosage levels.
Dose-dependent increases in time spent with ≥5% body weight reduction were observed with tirzepatide, contrasting with semaglutide.
Tirzepatide-treated participants had longer median duration of HbA1c ≤ 6.5% and ≥5% body weight reduction compared to semaglutide.

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AIMS: This participant-level exploratory analysis assessed the continuous time spent in glycaemic control and/or with sustained weight reductions with tirzepatide treatment in participants with type 2 diabetes (T2D) from the SURPASS programme.

MATERIALS AND METHODS: Participants (N = 6246) from SURPASS 1-5 were randomized to once weekly tirzepatide (5, 10 or 15 mg) or comparator (once weekly placebo, once weekly semaglutide 1 mg, insulin degludec or insulin glargine). Continuous time spent with HbA1c < 7.0% (53 mmol/mol), ≤6.5% (48 mmol/mol) and ≥5% body weight reduction and combined HbA1c ≤ 6.5% (48 mmol/mol) with a ≥5% body weight reduction were assessed through 40 weeks (SURPASS-1, -2, and -5) or 52 weeks (SURPASS-3 and -4). The non-parametric Wilcoxon rank sum test was used to compare the median duration of continuous time spent in control, and logistic regression was used to analyse the proportion of participants achieving glycaemic control and body weight reduction at any time points or at the end of the primary study period.

RESULTS: Median time spent with HbA1c < 7.0% (53 mmol/mol) was 80% (tirzepatide) versus 70% (semaglutide) and 0% (placebo) of the treatment duration in 40-week studies, and 77%-85% (tirzepatide) versus 62% (insulin degludec) and 23% (insulin glargine) of the treatment duration in 52-week studies (p < 0.001). Time spent with HbA1c < 7.0% (53 mmol/mol) was generally similar across all tirzepatide doses in each study. Dose-dependent increases in time spent with ≥5% body weight reduction were observed with tirzepatide (median time spent: 20%-77% with tirzepatide versus 25% with semaglutide 1 mg) (p < 0.001). Tirzepatide-treated participants experienced longer time spent with HbA1c ≤ 6.5% (48 mmol/mol) and ≥5% body weight reduction versus semaglutide (median: 35%-60% vs. 7%) (p < 0.001).

CONCLUSIONS: In this post hoc analysis, people with T2D experienced substantially longer continuous time in glycaemic control and more sustained body weight reductions with tirzepatide versus placebo and active comparators.

Key numbers

80%

Median Time with <7.0%

Compared to 70% for and 0% for .

20%-77%

Median Time with ≥5% Body Weight Reduction

Versus 25% for .

66%-85%

Composite Endpoint Achievement

Compared to 54% for .

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Abstract

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