medwireNews: People with insulin-dependent type 2 diabetes significantly improve their glycemic control, lose weight and require less insulin when they also receive a weekly injection of tirzepatide, the SURPASS-5 results show.
The improvements in glycated hemoglobin (HbA1c) are “robust and clinically significant,” said Dominik Dahl (group practice for internal medicine and diabetology, Hamburg, Germany), who presented the results in a current poster session at the virtual ADA 81st Scientific Sessions.
The 475 people enrolled in the study had an average age of about 60 years, had type 2 diabetes that lasted about 13 years, and were given a stable dose of insulin glargine, but needed a dose increase to get glycemic Achieve control.
During the 40-week follow-up period, people who happened to receive a placebo in addition to insulin achieved an average reduction in HbA1c of 0.93 percentage points compared to a baseline value of 8.37% (68 mmol / mol). However, this required an average daily insulin dose increase of 75.0% and they gained an average of 1.7 kg.
In contrast, individuals randomly assigned to take tirzepatide – a dual glucose-dependent insulinotropic polypeptide and a glucagon-like peptide (GLP) -1 receptor agonist – achieved an HbA1c reduction averaging 2.23.2, 59 and 2.59 percentage points with the 5, 10 and mg / week doses, respectively. The mean baseline HbA1c in the tirzepatide arms was 8.23–8.36% (66–68 mmol / mol).
Their insulin requirements increased by only 13.0% and 8.1% on average with the doses of 5 and 10 mg / week and decreased by 11.4% with the dose of 15 mg / week. In addition, with the three doses, their body weight decreased by an average of 6.2, 8.2 and 10.9 kg, respectively.
About 7 to 14% of participants who took tirzepatid had a decreased appetite compared to 1.7% of the placebo group, which may have contributed to weight loss.
The vast majority (93–97%) of participants in the tirzepatide groups achieved HbA1c levels of less than 7.0% (53 mmol / mol), compared to 34% in the placebo group, and 26–62% compared to 3 % achieved an HbA1c value with the non-diabetic area, below 5.7% (39 mmol / mol). Hypoglycemic events occurred at similar rates in all groups, including major events.
Gastrointestinal events were the most common adverse event, consistent with the established safety profile of GLP-1 receptor agonists. However, these occurred predominantly during the dose escalation phase, which lasted up to 20 weeks depending on the dose, and rarely occurred during the remainder of the follow-up period.
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Scientific meetings of the ADA; 25-29 June 2021
