Tirzepatide Reduces Risk for Progression from Prediabetes to T2D: Daily Dose

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On August 20, 2024, we reported on additional topline findings released by Eli Lilly from the 3-year SURMOUNT-1 study examined the efficacy and safety of once-weekly tirzepatide (Zepbound, Mounjaro) for long-term weight management and delay in progression to type 2 diabetes (T2D) in adults with prediabetes and obesity or overweight.

The study

SURMOUNT-1 was a global phase 3 registration trial of tirzepatide and the first to evaluate the medication’s safety and efficacy for weight reduction in adults without T2D. Study participants had obesity or overweight and at least 1 obesity-related comorbidity. Tirzepatide treatment was an adjunct to a study intervention of caloric reduction and increased physical activity.

Findings from the trial’s primary analysis after 72 weeks of treatment with tirzepatide or placebo were published in the New England Journal of Medicine in June 2022. Of the study’s original 2539 participants, the 1032 identified at baseline as having prediabetes remained enrolled for another 104 weeks and continued treatment with their original randomly assigned dose of weekly subcutaneous tirzepatide of 5 mg, 10 mg, or 15 mg, or placebo for a total treatment period of 176 weeks. The treatment period was followed by 17 weeks without treatment, for 193 weeks overall.

The findings

Weekly treatment with tirzepatide significantly reduced the risk of progressing from prediabetes to T2D by 94% among adults with the T2D precursor and obesity or overweight compared to placebo. Results also showed sustained weight loss through the 176-week treatment period, with adults who received the highest dose of tirzepatide (15 mg) reaching a 22.9% mean decrease in body weight compared to an average 2.1% weight loss among those treated with a placebo.

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