Tirzepatide: difference between revisions
Diff·revision 9 → 10·20:00, 28 Sep 2024
Difference between revision 9 and revision 10 of Tirzepatide. 10 lines changed; the page grew by 840 bytes.
| Revision 9 — 03:19, 9 Sep 2024 TitrationTheo (talk) clarify that the peptide backbone is acylated rather than PEGylated 3,866 bytes +141 | Revision 10 — 20:00, 28 Sep 2024 SelectTrialSam (talk) add category for the drug class 4,706 bytes +840 | ||
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| 27 | Why dual agonism outperforms GLP-1 monotherapy is not settled. Proposed contributions include GIP action on adipose tissue, central GIP-receptor effects on nausea that permit higher effective exposure, and restored beta-cell GIP responsiveness under ambient GLP-1 signalling. The trials were not designed to separate these, and cross-trial comparison of tirzepatide with semaglutide is confounded by differences in population and escalation.{{r|frias2021}} | 27 | Why dual agonism outperforms GLP-1 monotherapy is not settled. Proposed contributions include GIP action on adipose tissue, central GIP-receptor effects on nausea that permit higher effective exposure, and restored beta-cell GIP responsiveness under ambient GLP-1 signalling. The trials were not designed to separate these, and cross-trial comparison of tirzepatide with semaglutide is confounded by differences in population and escalation.{{r|frias2021}} |
| 28 | 28 | ||
| + | 29 | == Clinical evidence == | |
| + | 30 | | Trial | Population | Dose | Primary result | | |
| + | 31 | |---|---|---|---| | |
| + | 32 | | SURPASS-2 | T2D, on metformin | 5/10/15 mg | HbA1c −2.01 to −2.30% vs semaglutide −1.86% | | |
| + | 33 | | SURMOUNT-1 | Obesity, no T2D | 5/10/15 mg | −15.0% to −20.9% weight vs −3.1% at 72 wk | | |
| + | 34 | | SURMOUNT-2 | Obesity with T2D | 10/15 mg | −12.8% to −14.7% weight vs −3.2% | | |
| + | 35 | | SURPASS-CVOT | T2D, high CV risk | 5–15 mg | Non-inferior to dulaglutide for MACE | | |
| + | 36 | ||
| + | 37 | The [[SURPASS trial programme|SURPASS]] programme covers the glycaemic indication and the [[SURMOUNT trial programme|SURMOUNT]] programme the obesity indication. SURPASS-2 is one of the few head-to-head trials in this field, comparing tirzepatide directly with semaglutide 1 mg — not the 2.4 mg obesity dose, a distinction routinely lost when the trial is cited.{{r|frias2021}} | |
| + | 38 | ||
| 29 | == References == | 39 | == References == |
| 30 | {{reflist}} | 40 | {{reflist}} |