Horn Deborah B, Kahan Scott, Batterham Rachel L, Cao Dachuang, Lee Clare J, Murphy Madhumita, Gonsahn-Bollie Sylvia, Chigutsa Farai, Stefanski Adam, Dunn Julia P
University of Texas, McGovern Medical School, Houston, Texas, USA.
George Washington University School of Medicine, Washington, DC, USA.
Clin Obes. 2025 Jun;15(3):e12734. doi: 10.1111/cob.12734. Epub 2025 Jan 12.
The rate of weight reduction during obesity treatment declines over time and eventually reaches a weight plateau. We investigated factors associated with time to weight plateau (TTWP) in tirzepatide-treated participants with obesity or overweight in a post-hoc analysis of SURMOUNT-1 and SURMOUNT-4 trials. Participants adherent to tirzepatide treatment and achieving ≥5% weight loss by primary endpoint (week 72 SURMOUNT-1; week 88 SURMOUNT-4) were included. Weight plateau was defined as a weight change <5% over a 12-week interval and all subsequent 12-week intervals. TTWP was time from randomization to the start of the first 12-week interval. Association between baseline characteristics and TTWP was assessed. Overall, 1438 participants in SURMOUNT-1 and 259 in SURMOUNT-4 were included. Across BMI categories (overweight, class I, II, and III), median TTWP in SURMOUNT-1 was 24.3, 26.0, 36.1, and 36.1 weeks, respectively (p <.05, class II and III vs. overweight). By week 72, 90.2%, 88.9%, 87.6%, and 87.8% of participants in SURMOUNT-1 had reached a weight plateau across respective BMI categories [Correction added on 22 January 2025, after first online publication: The "72%" has been changed to "72" in this version.]. Higher doses of tirzepatide (10/15 mg), younger age, and female sex were more likely to reach a weight plateau later. Results in SURMOUNT-4 were similar. In this post-hoc analysis, most participants reached a weight plateau by week 72. Higher doses of tirzepatide, younger age, and female sex were associated with a longer TTWP. Further research into modifiers of weight reduction phases with tirzepatide may inform treatment decisions for its use in chronic weight management. Clinical Trial Registration: ClinicalTrials.gov, identifiers NCT04184622 (SURMOUNT-1) and NCT04660643 (SURMOUNT-4), available at http://www.clinicaltrials.gov/.
肥胖治疗期间的体重减轻速率会随着时间下降，最终达到体重平台期。在SURMOUNT - 1和SURMOUNT - 4试验的事后分析中，我们研究了替尔泊肽治疗的肥胖或超重参与者中与体重平台期时间（TTWP）相关的因素。纳入了坚持替尔泊肽治疗并在主要终点（SURMOUNT - 1第72周；SURMOUNT - 4第88周）实现体重减轻≥5%的参与者。体重平台期定义为在12周间隔以及随后所有12周间隔内体重变化<5%。TTWP是从随机分组到第一个12周间隔开始的时间。评估了基线特征与TTWP之间的关联。总体而言，SURMOUNT - 1纳入了1438名参与者，SURMOUNT - 4纳入了259名参与者。在不同BMI类别（超重、I类、II类和III类）中，SURMOUNT - 1的中位TTWP分别为24.3、26.0、36.1和36.1周（P<0.05，II类和III类与超重相比）。到第72周时，SURMOUNT - 1中各BMI类别分别有90.2%、88.9%、87.6%和87.8%的参与者达到体重平台期[2025年1月22日首次在线发表后添加的修正：此版本中“72%”已改为“72”]。更高剂量的替尔泊肽（10/15毫克）、年轻以及女性更晚达到体重平台期。SURMOUNT - 4的结果相似。在这项事后分析中，大多数参与者在第72周时达到体重平台期。更高剂量的替尔泊肽、年轻以及女性与更长的TTWP相关。对替尔泊肽减肥阶段调节因素的进一步研究可能会为其在慢性体重管理中的应用提供治疗决策依据。临床试验注册：ClinicalTrials.gov，标识符NCT04184622（SURMOUNT - 1）和NCT04660643（SURMOUNT - ），可在http://www.clinicaltrials.gov/获取。
