Tirzepatide reduces body weight across body mass index (BMI) categories: A SURMOUNT-1 pre-specified analysis

Question Is tirzepatide (TZP 5, 10, 15mg) efficacious in reducing body weight across different classes of obesity?

Methodology Adult participants, with obesity, or overweight (OW) with weight-related comorbidities (excluding diabetes), were randomised (1:1:1:1) to once-weekly TZP, or placebo (PBO). Percent change from baseline in body weight (BW) and proportion of participants achieving ≥ 5%BW reduction at week72 were assessed in participants with BMI ≥ 27 –<30 (OW), ≥ 30 –<35 (Class 1 obesity), ≥ 35 –<40 (Class 2 obesity), and ≥ 40kg/m² (Class 3 obesity). On-treatment data prior to discontinuation of study drug were used for analysis.

Results 2539 adults were randomised (female=68%, mean age=45 years, BW=104.8kg, BMI=38.0kg/m²). All TZP doses lowered BW vs PBO regardless of baseline BMI category (p<0.001). Estimated treatment difference (95%CI) of TZP 5, 10, and 15mg, respectively, vs PBO for the%BW change from baseline was: -13.6% (-18.0,-9.3), -15.2% (-19.6,-10.8), and -15.2% (-19.6,-10.7) in OW; -13.9% (-15.7,-12.2), -19.3% (-21.1,-17.5), and -18.6% (-20.4,-16.7) in Class 1 obesity; -13.3% (-15.3,-11.2), -20.0% (-22.0,-17.9), and -22.5% (-24.5,-20.4) in Class 2 obesity; and -13.4% (-15.5,-11.3), -18.2% (-20.2,-16.2), and -20.3% (-22.3,-18.3) in Class 3 obesity. The proportion of participants achieving ≥ 5%BW reduction in each BMI category, respectively, was significantly greater with TZP (92-100%, 90-98%, 90-98%, and 87-97%) vs PBO (30%, 28%, 25%, and 30%).

Conclusions In adults with obesity, each TZP dose led to significant BW reductions vs PBO irrespective of baseline BMI. TZP doses 10, 15mg led to greater BW reductions.

Interessenkonflikt

Abstract previously presented at ObesityWeek; San Diego; 1–4 November 2022; This study was funded by Eli Lilly and Company; Authors' COI:CWLR reports grants from Irish Research Council, Health Research Board, Science Foundation Ireland and Anabio, consulting fees from Novo Nordisk, Eli Lilly, Johnson & Johnson, Boerhinger Ingelheim and GI Dynamics and Herbalife; honoraria for lectures/speaker bureau for Novo Nordisk, Herbalife and Johnson & Johnson, travel support for attending meetings from Novo Nordisk, Herbalife and Johnson & Johnson. Leadership or fiduciary role (unpaid) at the Irish Society for Nutrition and Metabolism. Previous Chief medical officer and Director of the Medical Device Division of Keyron in 2011. Both of these were unremunerated positions. Previous investor in Keyron, which develops endoscopically implantable medical devices intended to mimic the surgical procedures of sleeve gastrectomy and gastric bypass. The product has only been tested in rodents and none of Keyron’s products are currently licensed. They do not have any contracts with other companies to put their products into clinical practice. No patients have been included in any of Keyron’s studies and they are not listed on the stock market; gifted stock holdings in September 2021 and divested all stock holdings in Keyron in September, 2021. He continues to provide scientific advice to Keyron for no remuneration.; - AMJ conducts multi-center trials with Eli Lilly, Novo Nordisk, and Rhythm Pharmaceuticals; serves on scientific advisory boards for Boehringer Ingelheim, Eli Lilly, Intellihealth, Novo Nordisk, Pfizer, Rhythm Pharmaceuticals, and WW; consults for Scholar Rock; and receives institutional grant funding from NIH/NIDDK.; - LJA reports receiving consulting fees from/and serving on advisory boards for Allurion, Altimmune, Atria, Gelesis, Jamieson Wellness, Janssen Pharmaceuticals, Jazz Pharmaceuticals, Novo Nordisk, Pfizer, Optum, Eli Lilly, Senda Biosciences and Versanis; receiving research funding from Allurion, Astra Zeneca, Gelesis, Janssen Pharmaceuticals, Novo Nordisk and Eli Lilly; having equity interests in Allurion, ERX Pharmaceuticals, Gelesis, Intellihealth, Jamieson Wellness and Myos Corp; and serving on a board of directors for ERX Pharmaceuticals, Intellihealth and Jamieson Wellness.; - RM, NA, BL, MCB, SZ and AS are employees and shareholders of Eli Lilly and Company.

Publikationsverlauf

Artikel online veröffentlicht:
02. Mai 2023