Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes.
The dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist, tirzepatide is under development for the treatment of type 2 diabetes. There is less knowledge about the efficacy and safety of once-weekly tirzepatide in comparison to semaglutide which is a selective GLP-1 receptor agonist. Juan P. Frías and colleague has conducted a study under the title “Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes” published in the New England Journal of Medicine under the title. The summary of this study is given below:
Objective:
To assess the efficacy and safety of tirzepatide at different doses with semaglutide at a dose of 1 mg in patients with type 2 diabetes.
Method:
This was an open-label, 40-week, phase 3 trial, with 1879 participants who were randomly assigned in 1:1:1:1 ratio to receive tirzepatide (5 mg, 10 mg, or 15 mg) or semaglutide (1mg). Participants had a baseline measure of 8.28% mean glycated hemoglobin level, mean weight of 93.7 kg, and mean age 56.6 years. The main endpoint was the improvement in the glycated hemoglobin level from baseline to 40 weeks.
Findings:
The study found superiority of tirzepatide at a dose of 5 mg, 10 mg, or 15 mg to semaglutide at a dose of 1 mg. There was a reduction in the glycated hemoglobin level as well as body weight in patients with type 2 diabetes who were receiving metformin in tirzepatide group. Additionally, there was an improvement in lipid profile, blood pressure, biomarkers of insulin sensitivity, and liver enzyme levels in tirzepatide receiving patients.
The most common reason for premature discontinuation was adverse events with tirzepatide 10 mg and 15 mg as compared to semaglutide and tirzepatide 5 mg.
Limitation:
The treatment could not be blinded due to differences in devices and dose-escalation schemes. Secondly, the study was for a short duration and the number of black patients was low. Lastly, the higher dosage of semaglutide was not available during the trial period.
Image Credit : People photo created by senivpetro – www.freepik.com