Tirzepatide (TZP) is a novel dual GIP/GLP-1 receptor agonist in development for glucose-lowering in T2D. The open-label SURPASS-4 trial examined TZP vs. insulin glargine (iGlar) in adults with T2D inadequately controlled on oral medications. Participants (N=1989) with baseline HbA1c 7.5-10.5% and BMI ≥25 kg/m2 were randomized 1:1:1:3 to once weekly TZP (5, 10, 15 mg) or iGlar (100 U/mL) titrated to <100 mg/dL fasting glucose. This post hoc analysis evaluated the sustainability of glycemic control after the 52-week (wk) primary endpoint (last on-treatment visit post-52 wks, up to 1wks) , (median=85 wks) . After achieving the 52-wk HbA1c targets of <7%, ≤6.5%, or <5.7%, a participant was considered to have sustained long-term HbA1c control if the final, post-52-wk, on-treatment HbA1c measurement increased ≤0.2% from the 52-wk HbA1c target (Table) . More participants in all 3 TZP dose groups maintained each of the 3 HbA1c targets beyond 52 wks vs. iGlar (all TZP, p<0.05) . Thus, even for the lowest TZP dose (5 mg) , 59% of participants achieved an HbA1c ≤6.5% at 52 wks, with 75% of these having ≤0.2% increase at their last visit. In contrast, for iGlar, 29% achieved an HbA1c ≤6.5%, with 66% of these having ≤0.2% increase.

In conclusion, TZP treatment results in improved long-term HbA1c control for a significantly greater percentage of adults with T2D compared to iGlar.


E.Pearson: Speaker's Bureau; Sanofi. S.Del prato: Advisory Panel; Applied Therapeutics, Eli Lilly and Company, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Sanofi, Consultant; Menarini Group, Research Support; AstraZeneca, Boehringer Ingelheim International GmbH, Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck & Co., Inc., Sanofi, Stock/Shareholder; Novo Nordisk A/S. I.Pavo: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. D.R.Franco: Advisory Panel; Abbott Diabetes, Medtronic, Novo Nordisk, Sanofi, Research Support; Eli Lilly and Company, Speaker's Bureau; Abbott Diabetes, AstraZeneca, Medtronic, Roche Diabetes Care, Sanofi. Z.Yang: Employee; Eli Lilly and Company. R.Wiese: Employee; Eli Lilly and Company. S.E.Kahn: Advisory Panel; Bayer AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Intarcia Therapeutics, Inc., Merck & Co., Inc., Novo Nordisk, Pfizer Inc.

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