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Phase 3 RCT (double-blind, placebo-controlled) · PMID 37385275

Tirzepatide Once Weekly for the Treatment of Obesity in People with Type 2 Diabetes (SURMOUNT-2) — VialBase Research

14.7% mean weight loss with tirzepatide 15mg at 72 weeks in T2D patients

Last updated · 2023 · Garvey WT, Frias JP, Jastreboff AM, et al. · Lancet
Key findings
  • 14.7% mean weight loss with tirzepatide 15mg at 72 weeks in T2D patients
  • 12.8% weight loss with 10mg dose
  • HbA1c reduction of 2.1% with 15mg (baseline ~8.3%)
  • 938 adults with T2D and obesity enrolled across 7 countries

Summary

SURMOUNT-2 evaluated tirzepatide 10mg and 15mg vs placebo for weight management in adults with type 2 diabetes and obesity. The trial enrolled 938 adults (BMI ≥27, HbA1c 7-10%) across seven countries, with 72 weeks of treatment plus lifestyle intervention.

Key Findings

  • Mean weight loss at 72 weeks:
    • 10mg: -12.8% (vs -3.2% placebo)
    • 15mg: -14.7%
  • HbA1c reduction:
    • 10mg: -2.1%
    • 15mg: -2.1%
  • Proportion achieving ≥5% weight loss: 79% (10mg), 83% (15mg) vs 32% placebo
  • Proportion achieving ≥15% weight loss: 32% (10mg), 40% (15mg) vs 4% placebo
  • Notable that weight loss is lower in T2D populations (14.7% vs 22.5% in SURMOUNT-1) — a consistent observation across incretin therapies
  • Similar tolerability profile to SURMOUNT-1
  • Co-primary endpoints: weight change and proportion achieving ≥5% weight loss — both met

Relevance to Tirzepatide

SURMOUNT-2 established tirzepatide’s efficacy in the harder-to-treat T2D obesity population, where insulin resistance and metabolic dysfunction typically blunt weight-loss medication effects. The 14.7% weight loss with 15mg significantly exceeded historical results for any anti-obesity medication in T2D patients (including Semaglutide at ~10% in STEP 2). The dual benefit of substantial weight loss plus robust glycemic control (2.1% HbA1c reduction) positions tirzepatide as a uniquely valuable therapy for the large population of patients with both obesity and T2D.

Citation

Garvey WT, Frias JP, Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023;402(10402):613-626. doi:10.1016/S0140-6736(23)01200-X.

See Also

View on PubMed · PMID 37385275 →