Tirzepatide for prevention of type 2 diabetes

• double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo
  
  
• analysis involved the participants with both obesity and prediabetes, who received their assigned dose of tirzepatide or placebo for a total of 176 weeks, followed by a 17-week off-treatment period
  
  
• at 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was:
  • −12.3% with the 5-mg dose,
  • −18.7% with the 10-mg dose,
  • −19.7% with the 15-mg dose,
  • −1.3% among those who received placebo (P<0.001 for all comparisons with placebo)
    
    
• fewer participants received a diagnosis of type 2 diabetes in the tirzepatide groups than in the placebo group (1.3% vs. 13.3%; hazard ratio, 0.07; 95% confidence interval [CI], 0.0 to 0.1; P<0.001)
  
  
• after 17 weeks off treatment or placebo, 2.4% of the participants who received tirzepatide and 13.7% of those who received placebo had type 2 diabetes (hazard ratio, 0.12; 95% CI, 0.1 to 0.2; P<0.001)
  • off treatment from tirzepatide, there was an estimated mean weight regain of 7% was observed over the 17-week off-treatment period

The study authors concluded that:

• three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo

Reference:

1. Jastreboff AM et al. Tirzepatide for Obesity Treatment and Diabetes Prevention. NEJM November 13, 2024