Long-term efficacy and safety of tirzepatide in participants with type 2 diabetes with inadequate glycaemic control on metformin and/or sulfonylurea: Post-hoc analysis of SURPASS-4.
Guan. Haixia H; Jiang. Hongwei H; Yuan. Huijuan H; Sun. Jie J; Xu. Jiawei J; Ji. Linong L
Key Findings
- HbA1c fell ~2.3‑2.6% with tirzepatide vs 1.0% with insulin glargine
- Body weight dropped 7.6‑11.4 kg with tirzepatide vs a 2.1 kg gain on insulin glargine
- Hypoglycaemia was less common on tirzepatide; GI side effects were mild‑moderate
Practical Outcomes
- For biohackers, tirzepatide at 10‑15 mg weekly can be a powerful tool to sharply improve glucose control and shed substantial weight, with a lower risk of dangerous hypoglycaemia. Users should start at the lower dose, watch for nausea or diarrhea, and ideally do this under medical supervision because it’s a prescription drug.
Summary
In a 2‑year study, tirzepatide (5‑15 mg weekly) cut blood‑sugar levels far more than insulin glargine and caused big weight loss (about 8‑11 kg) in people with type 2 diabetes who were still uncontrolled on metformin or sulfonylureas. It also led to fewer low‑blood‑sugar episodes and only mild‑to‑moderate stomach side effects.
Abstract
To evaluate the long-term efficacy and safety data at 104 weeks in tirzepatide-treated participants with type 2 diabetes who had inadequate glycaemic control on metformin and/or sulfonylurea. This post-hoc analysis was based on the SURPASS-4 data (NCT03730662), a multicenter, Phase III trial. Participants were randomised to receive tirzepatide (5, 10, or 15 mg) or insulin glargine. The primary efficacy endpoint was change in HbA1c levels from baseline to 104 weeks. Key secondary endpoints were changes in body weight and the proportion of participants achieving HbA1c <7.0%. Safety endpoints included the incidence of treatment-emergent adverse events (AEs) and hypoglycaemia. This post-hoc analysis included 1,500 participants. At Week 104, participants in the tirzepatide groups had significantly greater mean reduction in HbA1c (5 mg: -2.3%, 10 mg: -2.5%, 15 mg: -2.6%) compared with the insulin glargine group (-1.0%) (p < 0.001). Participants in the tirzepatide groups had significantly greater reduction in body weight (5 mg: -7.6 kg, 10 mg: -10.0 kg, 15 mg: -11.4 kg) compared with the insulin glargine group (2.1 kg) (p < 0.001). Significantly more participants in the tirzepatide group achieved HbA1c <7.0% compared with the insulin glargine group (p < 0.001). The incidence of hypoglycaemia was lower in the tirzepatide groups, and gastrointestinal AEs were mild or moderate in severity. Tirzepatide significantly improved glycaemic control and body weight reduction compared to insulin glargine over 104 weeks in participants with type 2 diabetes inadequately controlled on metformin and/or sulfonylurea. The safety profile of tirzepatide was acceptable, with a lower incidence of hypoglycaemia than insulin glargine.
Study Information
pubmed
2025
2025-09-09T00:00:00.000Z
10.1111/dom.70047
36