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Tirzepatide helps obese adults without diabetes lose 15% to 21% of their body weight over 72 weeks
Clinical Question
Does tirzepatide safely help patients lose more weight than placebo?
Bottom line
In obese patients without diabetes, those taking tirzepatide lost 15% to 21% of their body weight (compared with 3% for those taking placebo) over a 72-week period. The lowest cost on goodrx.com was $967 per month for four 10-mg cartridges for injection. 1b
Reference
Study design: Randomized controlled trial (double-blinded)
Funding: Industry
Setting: Outpatient (any)
Synopsis
Tirzepatide (trade name: Mounjaro) is a glucagon-like peptide-1 receptor agonist developed to treat type 2 diabetes mellitus. This study identified adults with a body mass index (BMI) greater than 30.0 kg/m2 or a BMI greater than 27.0 and at least one weight-related complication, such as hypertension, sleep apnea, cardiovascular disease, or dyslipidemia. Patients with diabetes were excluded. The mean age of the 2539 patients was 45 years, 67% were women, and 60% had a BMI greater than 35.0. Allocation concealment was not described, but groups were balanced at the start of the study. The patients were randomized to receive tirzepatide 5 mg, 10 mg, or 15 mg or matching placebo injection once weekly. Approximately 86% of participants completed the 72-week study. The percentage reduction in weight was 15% in the 5-mg group, 19.5% in the 10-mg group, 20.9% in the 15-mg group, and only 3.1% in the placebo group. Reductions were also seen in metabolic markers, such as systolic blood pressure (6.2 mm Hg) and low-density lipoprotein cholesterol (4.2 mg/dL). Serious adverse events were rare and evenly distributed among groups. Discontinuation due to adverse events was 2.6% in the placebo group and 4.3% to 7.1% in the tirzepatide groups.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Comments
GLP1 RA use in non diabetics
Is there safety concerns here , and how about diabetics ? Are they expected to have same benefits ?
In SURMOUNT, 11% weight loss…
In SURMOUNT, 11% weight loss was seen in patient with diabetes on the highest dose of tirzepatide. Across interventions for chronic weight management (behavioural, pharmacologic, and surgical) patients with diabetes consistently lose less weight than their normoglycemic counterparts.
Cost per pound?
Best estimate = ~ $1k/1% - any other estimates?
(ie. $1000per kg for a 200lb person).
Loss at 2.0 years not reported . . .
Cost, long term effect
Including cost was very helpful.
Please do a Joule report on any articles/data re: weight after the treatment period, when patients stop meds (should be a required step in these weight loss med studies)
Obesity is a chronic disease…
Obesity is a chronic disease, and thus, weight regain is expected when patients discontinue the medications. Anti-obesity medications are prescribed with intended long-term use, as for medications for diabetes and hypertension.
Tirzepatide and weight loss
There is insufficient data to allow a full critique: it is not even clear if the treated and untreated cohorts were each 2,539 or if this was the total for both groups - hence, the stated 86% who completed the study cannot be enumerated.
From the figures, the total percentage of anyone you lost weight was 55.4% - so 44.6% didn't loose any weight or didn't reach the lowest parameter of 15%.
3 years to loose, at best 20.9% with the highest dose and stated to be a cost of US$12,666 per year (total $38,0000) verges on medical madness.
e.g a 300 lb patient using the highest dose would lose 63 lbs over 72 months = 0.88 lb per month or 0.22 lb per week which, if 1 lb of fat equals 3,500 calories, would equal a net deficit of 700 calories per week or 100 cals per day.
A simple cheese sandwich = approx 500 calories.
Need more be said? Well, OK: - Generously, and approximately, a home-made cheese sandwich would cost no more than $2.00 or $3.00 for 750 calories per week . . in 72 months, a the saving would be 4 x $3.00 x 72 = $854 .... and compared to: -
US$38,000 x 3 = $114,000 in Tirzepide drug cost plus paraphernalia etc.
And, after stopping the drug after 3 years, any lost weight will almost certainly be regained.
patient-language
I hope that POEMs will begin to consistently use patient-first language when discussing patient with obesity.
tirzepatide for wt loss in non diabetics
effective but very expensive