Hamza Malak, Papamargaritis Dimitris, Davies Melanie J
Diabetes Research Centre, University of Leicester, Leicester, UK.
Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
Expert Opin Pharmacother. 2025 Jan;26(1):31-49. doi: 10.1080/14656566.2024.2436595. Epub 2024 Dec 4.
Tirzepatide is a once-weekly dual agonist, acting on glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors. It is approved at the same doses (5, 10 and 15 mg) for both type 2 diabetes (T2D) and chronic weight management.
Following a search in PubMed, clinicaltrials.gov, conference abstracts and Lilly website, we review herein the global phase 3 SURMOUNT program on tirzepatide's safety and efficacy for chronic weight management. Additionally, we discuss findings from the regional SURMOUNT-CN and SURMOUNT-J trials (in East-Asian populations) and the phase 2 SYNERGY-NASH, phase 3 SURMOUNT-OSA and SUMMIT studies on tirzepatide's impact on obesity-related complications. We also explore the clinical implications of SURMOUNT program results, considerations for tirzepatide prescribing for overweight/obesity, ongoing research and evidence gaps.
Tirzepatide marks a new era in overweight/obesity treatment, enabling many to achieve ≥ 20% weight loss. It is well-tolerated with a safety profile similar to GLP-1 receptor agonists. Tirzepatide also results in clinically important improvements in multiple obesity-related complications including sleep apnea, metabolic-dysfunction associated steatohepatitis, heart failure with preserved ejection fraction and diabetes prevention. Ongoing trials will provide further data on tirzepatide's long-term safety, efficacy (including cardiovascular outcomes) and potential cost-effectiveness for managing overweight/obesity and/or T2D.
替尔泊肽是一种每周一次的双重激动剂，作用于胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）受体。它已被批准以相同剂量（5、10和15毫克）用于2型糖尿病（T2D）和慢性体重管理。
在对PubMed、ClinicalTrials.gov、会议摘要和礼来公司网站进行检索后，我们在此回顾了替尔泊肽用于慢性体重管理的全球3期SURMOUNT项目的安全性和有效性。此外，我们还讨论了区域SURMOUNT-CN和SURMOUNT-J试验（针对东亚人群）的结果，以及2期SYNERGY-NASH试验、3期SURMOUNT-OSA试验和SUMMIT试验中替尔泊肽对肥胖相关并发症影响的研究结果。我们还探讨了SURMOUNT项目结果的临床意义、替尔泊肽用于超重/肥胖治疗的处方考虑因素、正在进行的研究以及证据空白。
替尔泊肽标志着超重/肥胖治疗的新时代，使许多人能够实现≥20%的体重减轻。它耐受性良好，安全性与GLP-1受体激动剂相似。替尔泊肽还能使多种肥胖相关并发症在临床上得到重要改善，包括睡眠呼吸暂停、代谢功能障碍相关脂肪性肝炎、射血分数保留的心力衰竭以及糖尿病预防。正在进行的试验将提供关于替尔泊肽长期安全性、有效性（包括心血管结局）以及管理超重/肥胖和/或T2D的潜在成本效益的进一步数据。
