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Tirzepatide for Obesity Treatment and Diabetes Prevention.

Clinical visual abstract: Tirzepatide for Obesity Treatment and Diabetes Prevention.

Clinical Bottom Line

In a N Engl J Med randomized trial, Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo.…

Summary: In a N Engl J Med randomized trial, Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. Key reported results included At 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was -12.3% with the 5-mg dose, -18.7% with the 10-mg dose, and -19.7% with the 15-mg dose, as compared with -1.3% among those who…

PICO Summary

ElementDetail
PopulationWe performed a phase 3, double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo. The current analysis involved the participants with both obesity and prediabetes, who received their assigned dose of tirzepatide or placebo for a total of 176 weeks…
InterventionWe performed a phase 3, double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo.
ComparisonWe performed a phase 3, double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo.
OutcomeAt 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was -12.3% with the 5-mg dose, -18.7% with the 10-mg dose, and -19.7% with the 15-mg dose, as compared with -1.3% among those who received placebo (P<0.001 for all comparisons with placebo). Fewer participants received a diagnosis of type 2 diabetes in the tirzepatide groups than in the placebo group (1.3% vs. 13.3%; hazard ratio, 0.07; 95% confidence interval [CI], 0.0 to 0.1; P<0.001). After 17 weeks off…
RCT N Engl J Med · 2025

Tirzepatide for Obesity Treatment and Diabetes Prevention.

Primary RCT · Diabetes & glycaemia

Trial design
Diabetes & glycaemia Enrolled & assessed RANDOMISED RCT Intervention Active arm n = NR Comparator Comparator n = NR At 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was...
Proportion reaching endpoint
NR Reported percentage 12.3% Intervention 18.7% Comparator ARRSee PICO outcome
Reported result
12.3%
Primary abstract result
Results
176
Abstract-reported estimate
Interpretation
Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial...
Source conclusion
Limitations
95% CI not stated
Check full paper
⬡ Bottom Line

Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. (Funded by Eli Lilly; SURMOUNT-1 ClinicalTrials.gov...

Expert Commentary

This N Engl J Med randomized trial evaluated Tirzepatide for Obesity Treatment and Diabetes Prevention. The abstract describes the study as follows: We performed a phase 3, double-blind, randomized, controlled trial in which 2539 participants with obesity, of whom 1032 also had prediabetes, were assigned in a 1:1:1:1 ratio to receive tirzepatide at a once-weekly dose of 5 mg, 10 mg, or 15 mg or placebo. The current analysis involved the… The main reported results were: At 176 weeks, the mean percent change in body weight among the participants who received tirzepatide was -12.3% with the 5-mg dose, -18.7% with the 10-mg dose, and -19.7% with the 15-mg dose, as compared with -1.3% among those who received placebo (P<0.001 for all comparisons with placebo). Fewer participants received a diagnosis of type 2 diabetes in the tirzepatide groups than in the placebo group (1.3%… The authors conclude: Three years of treatment with tirzepatide in persons with obesity and prediabetes resulted in substantial and sustained weight reduction and a markedly lower risk of progression to type 2 diabetes than that with placebo. (Funded by Eli Lilly; SURMOUNT-1… The clinical value of the result depends on whether the trial population, comparator, follow-up and outcome match the decision in..

References

Jastreboff AM, le Roux CW, Stefanski A, et al.. Tirzepatide for Obesity Treatment and Diabetes Prevention.. N Engl J Med. 2025-Mar-06. doi:10.1056/NEJMoa2410819. PMID: 39536238.

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