EASD 2019 — Tirzepatide leads to favorable changes in HbA1c after several dose escalations


  • Brandon May
  • Conference Reports
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Takeaway

  • Tirzepatide conferred greater improvements in glycemia and weight loss than placebo when initiated at lower doses and escalated to higher doses in patients with type 2 diabetes (T2D).

Why this matters

  • Initial administration of an incretin hormone receptor agonist therapy at a low dose, followed by gradual dose escalation, may result in improved gastrointestinal-related tolerability.

Study design

  • Patients with T2D were randomly assigned to 1 of either 3 dose-escalation algorithms or placebo:
    • Tirzepatide 12 mg top dose (n=29), 4 mg then 8 mg, 4 weeks each.
    • Tirzepatide first 15 mg (15 mg-1) top dose (n=28), 2.5 mg for 2 weeks, 5 mg for 2 weeks, and 10 mg for 4 weeks.
    • Tirzepatide second 15 mg (15 mg-2) top dose (n=28), 2.5 mg and then 7.5 mg, 4 weeks each.
    • Placebo (n=26).
  • Funding: Eli Lilly and Company.

Key results

  • At 12 weeks, the changes in HbA1c from baseline (standard error) were greater for tirzepatide arms vs placebo [placebo, +0.2% [0.21] (+2.19 mmol/mol [2.30]); 12 mg, −1.7% [0.19] (−18.58 mmol/mol [2.08]); 15 mg-1, −2.0% [0.20] (−21.86 mmol/mol [2.19]); 15 mg-2, −1.8% [0.19] (−19.68 mmol/mol [2.08])].
  • Tirzepatide was also associated with greater weight loss during the 12-week period (placebo, −0.5 kg [0.86]; 12 mg, −5.3 kg [0.78]; 15 mg-1, −5.5 kg [0.80], and 15 mg-2, −5.7 kg [0.79]).

Limitations

  • Short overall follow-up and the relatively short dose-escalation phases.