Early-Onset Type 2 Diabetes and Tirzepatide Treatment: A Post Hoc Analysis From the SURPASS Clinical Trial Program

IF 14.8 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Care Pub Date : 2024-04-19 DOI:10.2337/dc23-2356

Philip Zeitler, Rodolfo J. Galindo, Melanie J. Davies, Brandon K. Bergman, Vivian T. Thieu, Claudia Nicolay, Sheryl Allen, Robert J. Heine, Clare J. Lee

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Abstract

OBJECTIVE We evaluated baseline characteristics of participants with early-onset type 2 diabetes (T2D) from the SURPASS program and tirzepatide’s effects on glycemic control, body weight (BW), and cardiometabolic markers. RESEARCH DESIGN AND METHODS This post hoc analysis compared baseline characteristics and changes in mean HbA1c, BW, waist circumference (WC), lipids, and blood pressure (BP) in 3,792 participants with early-onset versus later-onset T2D at week 40 (A Study of Tirzepatide [LY3298176] in Participants With Type 2 Diabetes Not Controlled With Diet and Exercise Alone [SURPASS-1], A Study of Tirzepatide [LY3298176] Versus Semaglutide Once Weekly as Add-on Therapy to Metformin in Participants With Type 2 Diabetes [SURPASS-2]) or week 52 (A Study of Tirzepatide [LY3298176] Versus Insulin Degludec in Participants With Type 2 Diabetes [SURPASS-3]). Analyses were performed by study on data from participants while on assigned treatment without rescue medication in case of persistent hyperglycemia. RESULTS At baseline in SURPASS-2, participants with early-onset versus later-onset T2D were younger with longer diabetes duration (9 vs. 7 years, P < 0.001) higher glycemic levels (8.5% vs. 8.2%, P < 0.001), higher BW (97 vs. 93 kg, P < 0.001) and BMI (35 vs. 34 kg/m2, P < 0.001), and a similarly abnormal lipid profile (e.g., triglycerides 167 vs. 156 mg/dL). At week 40, similar improvements in HbA1c (−2.6% vs. −2.4%), BW (−14 vs. −13 kg), WC (−10 vs. −10 cm), triglycerides (−26% vs. −24%), HDL (7% vs. 7%), and systolic BP (−6 vs. −7 mmHg) were observed in both subgroups with tirzepatide. CONCLUSIONS Despite younger age, participants with early-onset T2D from the SURPASS program had higher glycemic levels and worse overall metabolic health at baseline versus those with later-onset T2D. In this post hoc analysis, similar improvements in HbA1c, BW, and cardiometabolic markers were observed with tirzepatide, irrespective of age at T2D diagnosis. Future studies are needed to determine long-term outcomes of tirzepatide in early-onset T2D.

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早发 2 型糖尿病与替哌肽治疗：SURPASS 临床试验项目的事后分析

目的我们评估了 SURPASS 计划中早发 2 型糖尿病 (T2D) 参与者的基线特征以及替扎帕肽对血糖控制、体重 (BW) 和心脏代谢指标的影响。研究设计与方法本项事后分析比较了 3792 名早发与晚发 T2D 参与者在第 40 周时的基线特征以及平均 HbA1c、体重、腰围 (WC)、血脂和血压 (BP) 的变化（单靠饮食和运动无法控制血糖的 2 型糖尿病患者服用替扎帕肽 [LY3298176] 的研究 [SURPASS-1]）、2型糖尿病患者二甲双胍附加疗法中替唑帕肽[LY3298176]与塞马鲁肽每周一次的比较研究[SURPASS-2]）或第52周（2型糖尿病患者中替唑帕肽[LY3298176]与德格鲁德胰岛素的比较研究[SURPASS-3]）。研究分析了参与者在接受指定治疗期间的数据，在出现持续高血糖时未使用抢救药物。结果在 SURPASS-2 的基线研究中，早发与晚发 T2D 患者的年龄更小，糖尿病病程更长（9 年 vs. 7 年，P < 0.001），血糖水平更高（8.5% vs. 8.2%，P < 0.001）。5% vs. 8.2%，Pamp;lt; 0.001），体重（97 kg vs. 93 kg，Pamp;lt; 0.001）和体重指数（35 kg/m2 vs. 34 kg/m2，Pamp;lt; 0.001）较高，血脂也同样异常（如甘油三酯 167 vs. 甘油三酯 167 vs. 甘油三酯 34 kg/m2，Pamp;lt; 0.001）、甘油三酯 167 vs. 156 mg/dL）。第 40 周时，观察到两个亚组的 HbA1c（-2.6% vs. -2.4%）、体重（-14 kg vs. -13kg）、腹围（-10 cm vs. -10cm）、甘油三酯（-26% vs. -24%）、高密度脂蛋白（7% vs. 7%）和收缩压（-6 mmHg vs. -7mmHg）在使用替扎帕肽后均有类似改善。结论尽管 SURPASS 计划的早发性 T2D 参与者年龄较小，但与晚发性 T2D 参与者相比，他们的血糖水平较高，整体代谢健康状况较差。在这项事后分析中，无论确诊 T2D 时的年龄如何，使用替扎帕肽对 HbA1c、体重和心脏代谢指标都有类似的改善。未来还需要进行研究，以确定替扎帕肽对早发性 T2D 的长期疗效。

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来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.

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