Near-Normoglycemia and Insulin Regression Induced by Tirzepatide in Basal Insulin–Treated Type 2 Diabetes

In SURPASS-6, how efficacious and safe was tirzepatide (TZP) based on residual insulin use at Week 52?

Methods: In the SURPASS-6 trial, TZP was added to basal insulin glargine U100 in participants with inadequately controlled long-standing type 2 diabetes (T2D). “Insulin regressor” was defined as basal insulin discontinuation or<10 IU/day, and “insulin non-regressor” as≥10 IU/day, at 52 weeks. Included only participants receiving TZP at Week 52 (≥75% compliance) without rescue medication. Efficacy analyses used a mixed model for repeated measures.

Results: Overall, 145 and 496 TZP-treated participants were included in the insulin regressor vs. insulin non-regressor groups, respectively. At baseline, mean age was 58.4 vs. 58.2 years, and median basal insulin dose was 40.0 vs. 48.0 IU/day. From baseline to Week 52 in the insulin regressor and insulin non-regressor groups, respectively, mean HbA1c of 8.5% and 8.9% was reduced to 5.9% and 6.7%, while weight was substantially reduced by 16 kg and 8 kg. Clinically significant hypoglycemia was also less frequent in the insulin regressor group.

Conclusion: In basal insulin–treated T2D, participants who regressed on insulin use also achieved near-normoglycemia and substantial weight loss.

 

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Interessenkonflikt

V. T. T., H. P., J. K., and C. J. L. are employees and shareholder of Eli Lilly and Company. H. W. is a consultant for Eli Lilly and Company. J. R., served on scientific advisory boards and received honorarium or consulting fees from: Applied Therapeutics, Boehringer Ingelheim, Eli Lilly and Company, Hanmi Pharmaceutical, Intarcia Therapeutics, Novo Nordisk, Oramed Pharmaceuticals, Sanofi, Structure Therapeutics, Terns Pharmaceuticals, and Zealand Pharma. Received grants and research support from: Applied Therapeutics, Boehringer Ingelheim, Eli Lilly and Company, GlaxoSmithKline, Hanmi Pharmaceutical, Intarcia Therapeutics, Lexicon Pharmaceuticals, Merck, Novo Nordisk, Oramed Pharmaceuticals, Pfizer, and Sanofi. S. T., served on scientific advisory boards, received research support and received honorarium or consulting fees from: Eli Lilly and Company, GlaxoSmithKline, Novo Nordisk, and Sanofi. C. W., served on scientific advisory boards and/or received honorarium from: Abbott, Biomea Fusion, Eli Lilly and Company, and Novo Nordisk. Received research funding from: Bayer, Corcept Therapeutics, Eli Lilly and Company, Novo Nordisk, Regeneron, and Vanda Pharmaceuticals.

Publication History

Article published online:
28 May 2025