by Elana Gotkine

For patients with obesity and prediabetes, three years of tirzepatide yields substantial and sustained weight reduction and a reduced risk for progression to type 2 diabetes, according to a study published in the New England Journal of Medicine.

Ania M. Jastreboff, M.D., Ph.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues performed a phase 3, double-blind trial involving 2,539 participants with obesity (1,032 of whom also had prediabetes), who were randomly assigned to receive tirzepatide at a once-weekly dose of 5, 10, or 15 mg or placebo in a 1:1:1:1 ratio. The current analysis included the participants with obesity and prediabetes who received tirzepatide or placebo for 176 weeks followed by an off-treatment period of 17 weeks.

The researchers found that the mean percentage change in body weight at 176 weeks was −12.3, −18.7, and −19.7% for those receiving 5-, 10-, and 15-mg tirzepatide doses, respectively, compared with −1.3% for those receiving placebo.

Receipt of a diagnosis of type 2 diabetes occurred in fewer participants in the tirzepatide groups versus the placebo group (1.3 versus 13.3%; hazard ratio, 0.07). After 17 weeks off treatment, 2.4 and 13.7% of those who received tirzepatide and placebo, respectively, had type 2 diabetes (hazard ratio, 0.12). Apart from COVID-19, the most common adverse events were gastrointestinal, most of which were mild-to-moderate in severity.

"Tirzepatide therapy resulted in sustained weight reduction that was accompanied by a markedly lower risk of progression to type 2 diabetes than that with placebo," the authors write.

More information: Ania M. Jastreboff et al, Tirzepatide for Obesity Treatment and Diabetes Prevention, New England Journal of Medicine (2024). DOI: 10.1056/NEJMoa2410819

Journal information: New England Journal of Medicine 

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