Treatment with tirzepatide in adults with prediabetes and either obesity or overweight conditions has led to substantial weight loss and maintained diabetes prevention, with nearly 99% of participants remaining diabetes-free over 176 weeks.
Data from the SURMOUNT-1 study demonstrated that tirzepatide reduced the likelihood of developing type 2 diabetes by 94% across all pooled doses when compared to placebo over a three-year period. Results indicated that for every nine individuals treated with tirzepatide, one new case of diabetes could be prevented. Participants taking a 15 mg dose experienced an average weight loss of 22.9%.
Eli Lilly and Company presented detailed findings from the Phase 3 SURMOUNT-1 study, which is the longest tirzepatide trial to date at 176 weeks.
Weekly injections of tirzepatide (in pooled doses of 5 mg, 10 mg, and 15 mg) substantially lowered the risk of progressing to type 2 diabetes in adults with prediabetes and obesity or overweight, compared to those on a placebo, while maintaining an average weight reduction of 22.9% for the 15 mg dose over the full three-year period.
Tirzepatide is currently the only approved medication combining both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonists. Both of these gut hormones are released in response to nutrient intake and play essential roles in the incretin effect, which is responsible for regulating insulin.
Additional outcomes of the study indicated that tirzepatide contributed to better glycemic control, reductions in cardiometabolic risk factors (such as fasting insulin, blood pressure, and cholesterol levels), and an improvement in health-related quality of life, with these benefits persisting through the 176-week treatment period. A subsequent mediation analysis revealed that around half of the delayed onset of type 2 diabetes could be linked to weight loss induced by the medication, with the remaining delay attributed to other mechanisms of tirzepatide.
At the 193-week mark, which included 176 weeks of treatment followed by a 17-week period off-treatment, tirzepatide’s safety and tolerability were consistent with earlier findings at 72 weeks. Aside from COVID-19 cases, the most frequently reported side effects were gastrointestinal, generally mild to moderate, with nausea, diarrhea, and constipation being the most common.
About SURMOUNT-1
The SURMOUNT-1 (NCT04184622) study was a large-scale, multi-center, double-blind, placebo-controlled trial designed to evaluate tirzepatide’s safety and efficacy at doses of 5 mg, 10 mg, and 15 mg, compared to a placebo, alongside a reduced-calorie diet and increased physical activity in adults without type 2 diabetes who had obesity or were overweight with at least one comorbidity, such as high blood pressure, abnormal lipid levels, obstructive sleep apnea, or cardiovascular disease.
Among the 1,032 participants with prediabetes at the start, those in the tirzepatide group continued treatment for an additional 104 weeks following the initial 72-week period to assess changes in body weight and rates of diabetes progression compared to placebo after three years of treatment.
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