Tirzepatide, a once weekly GIP/GLP-1 receptor agonist in development for T2D, demonstrated superior glycemic control in the Phase 3 SURPASS clinical trial program. This post-hoc analysis assessed glycemic control with tirzepatide in participants stratified by baseline (BL) HbA1c (≤8.5%, >8.5%) . Mean change from BL in HbA1c was assessed in tirzepatide-treated participants (5, or 15 mg) from SURPASS-1 (monotherapy) , SURPASS-2 (add-on to MET) , SURPASS-3 (add on to MET ± SGLT2i) , SURPASS-4 (add-on to MET, SGLT2i, or sulfonylurea) and SURPASS-5 (add-on to insulin glargine ± MET) at trial endpoints (40 or 52 weeks) . Safety was also presented. Treatment comparisons were estimated using data while participants were on treatment and without rescue medications (efficacy estimand) . Across each SURPASS trial, ranges in mean BL HbA1c were 7.94-8.52%, mean BMI were 31.9-34.2 kg/m2 and mean diabetes duration were 4.7-13.3 years. At trial endpoints, HbA1c reductions from BL ranged from 1.55-2.14% in the BL HbA1c ≤8.5% subgroup and 2.70-3.46% in the BL HbA1c >8.5% subgroup (Table) . Gastrointestinal side effects were similar to those reported in the incretin class and hypoglycemic events (blood glucose <54 mg/dL or severe) were low. In conclusion, significant and clinically meaningful HbA1c reductions were observed with tirzepatide, irrespective of BL HbA1c.

Disclosure

G.Aleppo: Consultant; Insulet Corporation, Research Support; AstraZeneca, Dexcom, Inc., Eli Lilly and Company, Fractyl Health, Inc., Insulet Corporation, Novo Nordisk, Speaker's Bureau; Dexcom, Inc. C.De block: Advisory Panel; Abbott Diagnostics, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk, Research Support; Indigo Diabetes, Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk. J.A.Levine: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. E.Gomez-valderas: Employee; Lilly, Stock/Shareholder; Lilly. B.D.Benneyworth: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company.

Funding

Eli Lilly and Company

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.