Tirzepatide therapy can lead to weight reduction in patients with diabetes and can be considered an option for managing weight, according to study findings in the International Journal of Obesity.

Tirzepatide is the first dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) indicated for treating type 2 diabetes. This medication has been shown to reduce weight and other metabolic parameters among patients with diabetes. Researchers conducted a study to determine the safety and efficacy of weight reduction in patients taking tirzepatide. 

Data was collected from PubMed, Embase, and Cochrane databases and researchers searched for randomized control trials of tirzepatide and a placebo regimen. Interventions were required to last at least 12 weeks. Some exclusion criteria were nonrandomized studies, studies with an overlapping cohort, and the use of another weight-loss medication. 

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The primary endpoints were the average body weight change from baseline and the average percent body weight change. 

There were 397 studies identified using the search strategy and, after exclusion, 6 studies were included in the final analysis. Of the 4036 patients included, 922 (22.8%) were assigned 5 mg of tirzepatide, 927 (23%) received 10 mg, 1025 (25.4%) received 15 mg, and 983 (24,4%) received the placebo regimen.

The average change in body weight from baseline revealed the following mean differences compared to placebo:

  • 5 mg dose of tirzepatide: -7.7 kg (95% CI, -11.0 to -4.4; P <.001; I2, 94%) 
  • 10 mg dose of tirzepatide: -11.6 kg (95% CI, -18.8 to -4.3; P =.002; I2, 99%) 
  • 15 mg dose of tirzepatide: -11.8 kg (95% CI, -17.4 to -6.2; P <.001; I2, 98%)

The average percentage change in weight in patients taking tirzepatide compared to the placebo group had the following mean differences:

  • 5 mg dose of tirzepatide: -8.1% (95% CI, -11.0 to -5.2; P <.001; I2, 92%)
  • 10 mg dose of tirzepatide: -11.9% (95% CI, -18.1 to -5.6; P <.001; I2, 98%)
  • 15 mg dose of tirzepatide: -12.4% (95% CI, -17.2 to -7.5; P <.001; I2, 97%)

Results also show that tirzepatide reduced body mass index (BMI) and waist circumference. Compared with placebo, tirzepatide had an increased risk of developing some common adverse effects, including nausea (odds ratio [OR], 4.2; 95% CI, 2.4-7.5; P <.001), vomiting (OR, 7.0; 95% CI, 4.3-11.4; P <.001), and diarrhea (15 mg dose; OR, 2.8; 95% CI, 1.6-4.9; P <.001).

Study limitations are a high heterogeneity in studies, variations in treatment durations, and differences in baseline weight and BMI between studies. 

“The drug’s risk-to-benefit with each dose should be evaluated in an individualized manner in clinical practice,” study authors stated. “Whether the substantial effects on weight loss and adiposity will lead to a significant cardiovascular risk reduction remains to be determined.”

Reference

Lima de Mesquita YL, Calvi IP, Marques IR, et al. Efficacy and safety of the dual GIP and GLP-1 receptor agonist tirzepatide for weight loss: a meta-analysis of randomized controlled trials. Int J Obes. Published online July 17, 2023. doi:10.1038/s41366-023-01337-x

This article originally appeared on Endocrinology Advisor

Topics:

Diabetes Type 2 Diabetes Weight Management