Clinical Feasibility of a Low-Dose Tirzepatide Strategy in Older Adults with Type 2 Diabetes: Persistence, Metabolic Benefit, and Treatment Simplification in a Real-World Cohort.

IF 4.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2026-10-15 DOI:10.1016/j.eprac.2026.10.004

Ken Kanazawa, Koji Hayashi, Cao Xinyi, Mai Hijikata, Koichiro Kuwabara

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Abstract

Objective: To evaluate the clinical feasibility of a low-dose tirzepatide strategy in older adults with type 2 diabetes mellitus in routine outpatient practice.

Methods: This single-center retrospective cohort included Japanese adults who initiated tirzepatide between April 2024 and December 2025 and received a maximum observed dose of ≤5 mg/week through week 28. The primary endpoint in adults aged ≥65 years combined treatment persistence, absence of adverse event (AE)-related discontinuation, and either ≥3% weight loss or an HbA1c reduction ≥1.0 percentage point (≥11 mmol/mol). Younger adults were contextual comparators using overlap weighting.

Results: Among 122 tirzepatide initiators, 107 were included in the low-dose strategy cohort, including 37 older adults. The primary endpoint was achieved by 23/37 (62.2%); 33/37 (89.2%) remained on treatment, and 2/37 (5.4%) discontinued because of AEs. Median body weight change was -3.07%, median HbA1c change was -1.0 percentage point (-11 mmol/mol), and 19/37 (51.4%) achieved HbA1c <7.0% (<53 mmol/mol). Renal, hydration, and nutritional laboratory markers remained generally stable. Overlap-weighted comparisons showed no clear age-related attenuation.

Conclusion: In selected older adults, low-dose tirzepatide provided modest metabolic benefit with high persistence and infrequent AE-related discontinuation.

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低剂量替西肽治疗老年2型糖尿病的临床可行性：持久性、代谢益处和现实世界队列中的治疗简化

目的：探讨小剂量替西肽治疗老年2型糖尿病的临床可行性。方法：这项单中心回顾性队列研究纳入了在2024年4月至2025年12月期间开始使用替西帕肽的日本成年人，并在第28周之前接受了≤5mg /周的最大观察剂量。主要终点是年龄≥65岁的成年人，联合治疗持续，无不良事件（AE）相关的停药，体重减轻≥3%或HbA1c降低≥1.0个百分点（≥11 mmol/mol）。年轻人是使用重叠加权的语境比较者。结果：122例替西肽启动者中，107例纳入低剂量策略队列，包括37例老年人。主要终点达到23/37 (62.2%)；33/37（89.2%）患者继续接受治疗，2/37（5.4%）患者因不良反应而停止治疗。中位体重变化为-3.07%，中位HbA1c变化为-1.0个百分点（-11 mmol/mol）， 19/37（51.4%）达到HbA1c。结论：在选定的老年人中，低剂量替西帕肽提供适度的代谢益处，具有高持久性和罕见的ae相关停药。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.