Differences in weight reduction efficacy of tirzepatide in adults without versus with type 2 diabetes with overweight or obesity in SURMOUNT 1 and 2

What was the weight reduction (WR) efficacy observed with tirzepatide (TZP) in participants with overweight or obesity without type 2 diabetes (T2D, SURMOUNT (SM)-1) compared to with T2D (SM-2) after matching key baseline characteristics, given the higher WR efficacy with obesity treatment observed in people without T2D compared to people with T2D?

Methods: Propensity score matching was used to create a balanced cohort of participants from SM-1 (excluding TZP 5 mg) and SM-2 (excluding those on sulfonylurea or pioglitazone), matched by age, gender, weight, BMI, antidepressant use or depression, and obesity-related comorbidities (ORCs). MMRM was performed to compare the percent of WR at Week 72 between the groups.

Results: At baseline, SM-2 cohort was on average older with more males, lower weight, higher HbA1c and higher comorbidity burden, compared to SM-1. The differences in WR remained after balancing baseline characteristics in the propensity matched sample (mean age 51.6 vs 53.9 yrs, females 55% vs 55%, weight 103.3 vs 99.5 kg and≥2 ORCs 85% vs 85%).

Conclusion: The differences in WR efficacy with TZP between the SM-1 and SM-2 studies persisted after matching key baseline characteristics suggesting additional contributing factors.

Publication History

Article published online:
28 May 2025