Predictors of Initial and Sustained Glycemic and Weight Response to Tirzepatide: A Post Hoc Analysis of SURPASS-4

For tirzepatide-treated participants achieving HbA1c ≤48 mmol/mol (6.5%) at 52 weeks, 75-84% sustained this until study end (median 81 weeks).

• Factors predicting initial glycemic control included higher tirzepatide dose, shorter diabetes duration, lower HbA1c, better β-cell function, metformin use alone, and absence of albuminuria at baseline.
• Sustained glycemic control was associated with greater weight loss, a smaller decrease in fasting glucose, no use of sulfonylureas, and higher β-cell function at 52 weeks.
• For participants achieving ≥10% weight loss at 52 weeks, 79-82% maintained their weight loss.
• Predictors for achieving weight loss included higher tirzepatide dose, female sex, no history of cardiovascular disease, and lower baseline HbA1c, kidney function, and triglycerides.
• A greater decrease in LDL-cholesterol by 52 weeks was linked to maintained weight loss.

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