RCT · PMID 37385275

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

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Last updated · 2023 · Garvey, W.T., Frias, J.P., Jastreboff, A.M., le Roux, C.W., Sattar, N., Aizenberg, D., Mao, H., Zhang, S., Ahmad, N.N., Bunck, M.C. · Lancet
Key findings
  • Tirzepatide 15mg produced 14.7% weight loss in T2DM patients
  • Significant HbA1c reductions alongside weight loss
  • First obesity trial combining weight and glycemic endpoints in T2DM

Summary

SURMOUNT-2 evaluated tirzepatide for weight management specifically in adults with obesity and type 2 diabetes. While weight loss was somewhat lower than in the non-diabetes SURMOUNT-1 trial (as expected, since T2DM typically attenuates GLP-1-mediated weight loss), results remained clinically significant with dual benefits for weight and glycemic control.

Key Findings

  • Mean weight loss at 72 weeks: -12.8% (10mg) and -14.7% (15mg) vs -3.2% (placebo)
  • Mean HbA1c reduction: -2.1% (10mg) and -2.1% (15mg) vs -0.5% (placebo)
  • 81.6% (10mg) and 86.2% (15mg) achieved ≥5% weight loss
  • 30.2% (10mg) and 40.0% (15mg) achieved ≥20% weight loss
  • Consistent improvements in cardiometabolic markers
  • Safety profile consistent with prior tirzepatide trials

Methodology

Double-blind, placebo-controlled, phase 3 RCT in 938 adults with BMI ≥27 and T2DM (HbA1c 7-10%). Randomized 1:1:1 to tirzepatide 10mg, 15mg, or placebo weekly for 72 weeks. Co-primary endpoints: percent weight change and ≥5% weight loss at 72 weeks.

Limitations

  • Only tested 10mg and 15mg doses (no 5mg arm)
  • T2DM patients typically lose less weight on GLP-1 therapies — as seen here vs SURMOUNT-1
  • No active comparator (semaglutide or other)
  • Concomitant diabetes medications varied across participants
  • Predominantly recruited from specialty clinics

Relevance to Content

Important for content targeting the T2DM+obesity overlap population. Shows that while weight loss is somewhat attenuated in diabetes (14.7% vs 20.9% in SURMOUNT-1), dual weight/glycemic benefits make tirzepatide particularly valuable in this population. Useful for articles about metabolic health beyond weight alone.

See Also