1. Switching to Tirzepatide 5 mg From Glucagon-Like Peptide-1 Receptor Agonists: Clinical Expectations in the First 12 Weeks of Treatment.
- Author
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Jabbour S, Paik JS, Aleppo G, Sharma P, Gomez Valderas E, and Benneyworth BD
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Body Weight drug effects, Drug Substitution, Gastric Inhibitory Polypeptide, Glucagon-Like Peptide-2 Receptor, Glycated Hemoglobin analysis, Liraglutide administration & dosage, Liraglutide therapeutic use, Liraglutide adverse effects, Prospective Studies, Recombinant Fusion Proteins administration & dosage, Recombinant Fusion Proteins therapeutic use, Recombinant Fusion Proteins adverse effects, Blood Glucose drug effects, Blood Glucose analysis, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 blood, Glucagon-Like Peptide-1 Receptor Agonists administration & dosage, Glucagon-Like Peptide-1 Receptor Agonists adverse effects, Glucagon-Like Peptides analogs & derivatives, Glucagon-Like Peptides administration & dosage, Glucagon-Like Peptides therapeutic use, Glucagon-Like Peptides adverse effects, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents therapeutic use, Hypoglycemic Agents adverse effects, Immunoglobulin Fc Fragments administration & dosage, Immunoglobulin Fc Fragments therapeutic use, Immunoglobulin Fc Fragments adverse effects
- Abstract
Objective: This prospective study aimed to describe the clinical course in terms of glycemic outcomes, body weight, and adverse events during the first 12 weeks following a switch from glucagon-like peptide-1 receptor agonists (GLP-1 RAs) directly to tirzepatide 5 mg., Methods: Participants were ≥18 years with type 2 diabetes (T2D), glycated hemoglobin (HbA1c) ≥6.5% to ≤9.0%, body mass index ≥25 kg/m
2 and were on a stable treatment dose of GLP-1 RAs (liraglutide every day [1.2, 1.8 mg], semaglutide once-weekly [0.5, 1.0, 2.0 mg], or dulaglutide once-weekly [0.75, 1.5, 3.0, and 4.5 mg]) for ≥3 months at baseline. The primary end point was HbA1c change from baseline at week 12. Secondary end points included change from baseline in fasting serum glucose, body weight, and glucose assessed by continuous glucose monitoring. Safety was also assessed., Results: Participants were 58.3 years on average, with baseline HbA1c 7.39%, body mass index 35.18 kg/m2 , T2D duration around 12.4 years, and included 55% females. Semaglutide (55%) and dulaglutide (42%) were the most commonly used GLP-1 RAs at baseline with semaglutide 1.0 mg and dulaglutide 1.5 mg being the most common treatment doses. At week 12, mean HbA1c changed from baseline by -0.43%, fasting serum glucose by -7.83 mg/dL, and body weight by -2.15 kg (all P < .01). Glycemic outcomes and body weight improved in participants in all baseline GLP-1 RA subgroups. Twenty participants (13.2%) developed gastrointestinal events. Three (2%) participants discontinued tirzepatide due to adverse events. There were no severe hypoglycemic events or deaths., Conclusion: In this prospective study, when people with T2D on stable GLP-1 RA treatment were switched directly to tirzepatide 5 mg, they experienced improved glycemic outcomes and additional weight reduction with an acceptable risk of adverse gastrointestinal events over 12 weeks., Competing Interests: Disclosure S.J. reports consultancy fees from Eli Lilly and Company and Sanofi. G.A. received consulting fees from Dexcom, Insulet, and Medscape. J.S.P., P.S., E.G.V., and B.D.B. are employees and shareholders of Eli Lilly and Company., (Copyright © 2024 AACE. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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