NICE guidance - Tirzepatide for treating type 2 diabetes

NICE guidance - Tirzepatide for treating type 2 diabetes

NICE have stated:

Tirzepatide is recommended for treating type 2 diabetes alongside diet and exercise in adults when it is insufficiently controlled only if:

• triple therapy with metformin and 2 other oral antidiabetic drugs is ineffective, not tolerated or contraindicated, and
  
  
• they have a body mass index (BMI) of 35 kg/m2 or more, and specific psychological or other medical problems associated with obesity, or
  
  
• they have a BMI of less than 35 kg/m2, and:
  • insulin therapy would have significant occupational implications, or
  • weight loss would benefit other significant obesity-related complications

Use lower BMI thresholds (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds

The NICE committee stated "..Some people with type 2 diabetes have triple therapy with metformin and 2 other oral antidiabetic drugs. When this is ineffective, not tolerated or contraindicated, they may switch one of the antidiabetic drugs for a glucagon-like peptide-1 (GLP-1) receptor agonist (such as semaglutide) or start insulin therapy. For this evaluation, the company asked for tirzepatide to be considered only as an alternative to GLP-1 receptor agonists. This does not include everyone who it is licensed for.

Clinical trial results suggest that tirzepatide reduces blood glucose levels (measured by HbA1c levels) and body weight compared with semaglutide, insulin therapy or placebo. There is only an indirect comparison of tirzepatide with other GLP-1 receptor agonists, which suggests similar benefits, although these results are less certain.."

Reference:

• NICE (October 2023). Tirzepatide for treating type 2 diabetes