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SURMOUNT trial programme (revision 9)

Old revision·23:17, 6 Nov 2024·OpenLabelOtto

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SURMOUNT trial programme
STEP 1 · sema 2.4−14.9%SURMOUNT-1 · tirz 15−20.9%SURPASS-2 · tirz 15−11.2%TRIUMPH · reta 12−24.2%SCALE · lira 3.0−8.0%mean weight change at primary endpoint
Weight change by dose in the principal obesity trial.
DrugTirzepatide 5, 10 and 15 mg weekly
IndicationChronic weight management
Principal duration72 weeks
Topic infobox · conventions

The SURMOUNT trial programme is the phase 3 series that established tirzepatide for chronic weight management. SURMOUNT-1 randomised 2,539 adults with obesity and without diabetes to tirzepatide 5, 10 or 15 mg weekly or placebo for 72 weeks.[1]

Mean weight change was −15.0%, −19.5% and −20.9% at the three doses against −3.1% on placebo. Both arms received lifestyle counselling, so the placebo figure is not a no-treatment baseline; see Placebo-adjusted effect.[1]

SURMOUNT-2 studied participants with obesity and type 2 diabetes and reported smaller reductions — −12.8% and −14.7% at 10 and 15 mg against −3.2% — reproducing the attenuation of weight response in diabetes seen across this field.[2]

Constituent trials

[edit]
TrialPopulationDurationResult at highest dose
SURMOUNT-1Obesity, no diabetes72 weeks−20.9% vs −3.1%
SURMOUNT-2Obesity with type 2 diabetes72 weeks−14.7% vs −3.2%
SURMOUNT-3After intensive lifestyle lead-in72 weeksFurther loss after lead-in
SURMOUNT-4Randomised withdrawal after lead-in88 weeks totalRegain on withdrawal

SURMOUNT-4 is the counterpart of STEP 4 and addresses the same question: what happens when treatment stops. Participants randomised to placebo after a lead-in regained a substantial proportion of the weight lost. See Weight regain after discontinuation.[2]

SURMOUNT-3 shows that a lifestyle lead-in does not exhaust the available effect: participants who had already lost weight on intensive lifestyle intervention lost further weight on active treatment.[1]

References

  1. ^ a b c Jastreboff AM, Aronne LJ, Ahmad NN, et al. "Tirzepatide once weekly for the treatment of obesity." New England Journal of Medicine 387(3):205–216 (2022). DOI:10.1056/NEJMoa2206038. PMID 35658024.
  2. ^ a b Garvey WT, Frias JP, Jastreboff AM, et al. "Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2)." The Lancet 402(10402):613–626 (2023). PMID 37385275.