Physician Views Preview: Endocrinologists run the rule over new tirzepatide data

Positive Phase III data continues to accumulate for Eli Lilly’s potential first-in-class GIP/GLP-1 inhibitor tirzepatide in type 2 diabetes.

Most recently – and arguably most significantly in terms of future commercial impact – positive data was announced from the SURPASS-2 study, evaluating tirzepatide head-to-head against Novo Nordisk’s once-weekly GLP-1 agonist Ozempic.

See ViewPoints: Tirzepatide delivers most compelling data yet

Eli Lilly is expected to file tirzepatide with regulatory authorities later this year, setting up potential approval and launch in 2022.

With top-line data versus Ozempic now in the bag, we are fielding a short survey to endocrinologists to gauge how impressive these results are deemed to be and how they may impact future prescribing behaviour.

Specifically we are asking them…

Q. New Phase III clinical data show that treatment with the GIP/GLP-1 agonist tirzepatide led to superior A1C and body weight reductions from baseline across three doses compared to injectable semaglutide 1mg in adults with type 2 diabetes in the 40-week SURPASS-2 trial.

Top-line results show that the highest dose of tirzepatide (15mg) reduced A1C by 2.46% and body weight by 12.4 kg (27.3 lb., 13.1%). The lowest dose of tirzepatide (5mg) reduced A1C by 2.09% and body weight by 7.8 kg (17.2 lb., 8.5%) compared to semaglutide at 1.86% and 6.2 kg (13.7 lb., 6.7%).

How compelling are these head-to-head data?

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Q. Additionally, 51% of those taking tirzepatide 15 mg achieved an A1C of less than 5.7% – the level seen in people without diabetes – compared to 20% of those taking semaglutide. Do you think reductions in A1C of this magnitude could meaningfully differentiate tirzepatide from any other available treatment for type 2 diabetes?

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Q. Which of the efficacy endpoints demonstrated by tirzepatide resonates with you as most likely to drive your future utilisation of the drug (assuming it is approved by regulators)?

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Q. The most commonly reported adverse events across all treatment arms were gastrointestinal-related, including

  • nausea (17.4% [5 mg], 19.2% [10 mg], 22.1% [15 mg], 17.9% [semaglutide])
  • diarrhoea (13.2% [5 mg], 16.4% [10 mg], 13.8% [15 mg], 11.5% [semaglutide])
  • vomiting (5.7% [5 mg], 8.5% [10 mg], 9.8% [15 mg], 8.3% [semaglutide]).

Treatment discontinuation rates due to adverse events were 5.1% (5 mg), 7.7% (10 mg), 7.9% (15 mg) and 3.8 % (semaglutide).

Taking into account tirzepatide’s efficacy, is this side effect profile acceptable?

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Q. Based on what you know about tirzepatide, if it is approved by regulators how will you adopt it as a treatment for type 2 diabetes?

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Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here

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