751-P: Longer Time Spent in Glycemic Control after Initiating Tirzepatide vs. Comparators—Exploratory Analysis of SURPASS 1–5 Trials

Abstract

Conventional trials in people with T2D typically report HbA1c at study end as the primary outcome. In SURPASS 1-5 trials, 81-97% of adults with T2D treated with the GIP/GLP-1 receptor agonist tirzepatide (5, 10, or 15 mg) achieved an HbA1c <7.0% at the primary endpoint. Here we report the time spent in glycemic control throughout the duration of each trial. Participants were randomized to tirzepatide (5, 10, or 15 mg) or comparator (placebo in SURPASS 1 and 5, semaglutide 1 mg in SURPASS 2, insulin degludec in SURPASS 3, and insulin glargine in SURPASS 4), with primary treatment durations of 40 or 52 weeks (wks). Continuous time spent with HbA1c <7.0% was descriptively analyzed in all patients on treatment without rescue medication, with missing data imputed, in this post-hoc analysis. Participants on tirzepatide 5, 10, or 15 mg spent longer time with HbA1c <7.0% than comparators. In studies of 40 wks duration, median time spent with HbA1c <7.0% was 32 wks for all tirzepatide doses, 28 wks for semaglutide 1 mg, and 0 wks for placebo. In studies of 52 wks, this was up to 44 wks for tirzepatide, 32 wks for insulin degludec, and 12 wks for insulin glargine. Time spent with HbA1c <7.0% was generally similar across all tirzepatide doses in each study. To conclude, tirzepatide allowed greater continuous time spent with HbA1c <7.0% vs placebo, semaglutide 1 mg, and basal insulins. Disclosure J.Rosenstock: Advisory Panel; Applied Therapeutics Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Novo Nordisk, Oramed Pharmaceuticals, Sanofi, Zealand Pharma A/S, Intarcia Therapeutics, Inc., Hanmi Pharm. Co., Ltd., Research Support; Applied Therapeutics Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis, Novo Nordisk, Pfizer Inc., Sanofi, Intarcia Therapeutics, Inc. W.Garvey: Advisory Panel; Boehringer-Ingelheim, Novo Nordisk, Eli Lilly and Company, Merck & Co., Inc., Alnylam Pharmaceuticals, Inc., Fractyl Health, Inc., Inogen, Research Support; Novo Nordisk, Eli Lilly and Company, Epitomee, Pfizer Inc., Neurovalens. R.L.Batterham: Advisory Panel; Novo Nordisk, GlaxoSmithKline plc., Gila Therapeutics Ltd, Pfizer Inc., Consultant; Eli Lilly and Company, Novo Nordisk, Epitomee, Speaker's Bureau; Eli Lilly and Company, Novo Nordisk, GlaxoSmithKline plc. M.Liu: Consultant; Eli Lilly and Company. B.Bergman: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. A.Hemmingway: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. V.Thieu: None. Funding Eli Lilly and Company