By Joseph E. Scherger, MD, MPH
Core Faculty, Eisenhower Health Family Medicine, Residency Program, Eisenhower Health Center, La Quinta, CA; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles
Females, patients of white or Asian race, younger patients, and those taking metformin benefit the most from treatment with tirzepatide.
Malecki MT, Batterham RL, Sattar N, et al. Predictors of ≥ 15% weight reduction and associated changes in cardiometabolic risk factors with tirzepatide in adults with type 2 diabetes in SURPASS 1-4. Diabetes Care 2023;46:1-8.
An international team studied which patients benefited most from tirzepatide (Mounjaro) for treatment of type 2 diabetes. The authors looked at weight loss, glucose control, and reduction of cardiovascular risk factors, specifically reductions in non-high-density lipoprotein (HDL) cholesterol, triglycerides, alanine transaminase, waist circumference and blood pressure. The greatest benefit was seen with higher doses of the drug and in females, patients of white or Asian race, younger patients, and patients on concomitant metformin therapy. Weight loss of more than 15% of body weight was greater with better glycemic status and lower non-HDL cholesterol.
The study was funded by Eli Lilly, the manufacturer of tirzepatide.
COMMENTARY
The glucagon-like peptide 1 (GLP-1) analogs, semaglutide and tirzepatide, definitely work for weight loss and control of type 2 diabetes. Although the results are impressive, these medications are expensive. What is the long view with these two conditions? Both weight loss and type 2 diabetes can be treated with diet modification.
This multinational study showed the characteristics of patients who benefit most from tirzepatide, especially for weight loss. While this information is useful, all patients appear to benefit. More recent evidence suggests that tirzepatide is superior to semaglutide and leads to more and faster weight loss.1
This is a new therapeutic area for two of the most common chronic health problems, excess weight and type 2 diabetes. Much more evidence is likely to emerge with these medications. I hope that they will become less expensive and, hence, available to more people, assuming they prove helpful with the test of time.
REFERENCE
- Lapid N. Lilly’s Mounjaro leads to more and faster weight loss than Novo obesity frug, data analysis finds. Medscape Family Medicine. Reuters Health Information. Nov. 28, 2023. https://www.medscape.com/s/viewarticle/998824?ecd=wnl_dne3_231129_MSCPEDIT_etid6105952&uac=76356DG&impID=6105952
