GLP-1 Evidence

Lyf

Tirzepatide: hvat royndirnar vísa

Tirzepatide framdi tær størstu miðalvøttan vættatapsir, ið nakrantíð er skrásett fyri eitt lyf í einum tilfarið royndum um feitt. Tað er eisini tað, ið hevur tær mest áhugaverdu ikki-vøttan úrslit.

Uppdatert 3 min lesing 30 tilvísingar Dokumentasjonsstyrkur 5/5

Vøttur av ein týsk apotek sæð frá gøtuni
muckelfloh · CC BY 3.0 · Wikimedia Commons

SURMOUNT-1: størsta ávirkanarstødd í økinum

SURMOUNT-1 randomiserði vaksnar við feitt og uttan diabetes til tirzepatide 5, 10 ella 15 mg vikuliga, ella placebo, í 72 vikur [8]. Miðalvøttan broyting við hægsta doys var umleið −20,9%, við 5 mg doysum, ið longu var umleið −15% — tað merkir, at lægsta tirzepatide doys umleið svaraði til besta semaglutide úrslitið. Meira enn helvtin av luttakandi við hægri doysum misti í minsta lagi 20% av kropsvøttinum.

Ein framhald av tí programa útvidgaði uppfylgingina og boðaði frá diabetes fyribyrging saman við varandi vættataps [5], ið hevur týdning, tí tað flytir endapunktin frá einum tali á einum vøtt til einum kliniskum tilburði.

Vættataps virkni

Diabetes straffin ávirkar eisini her

SURMOUNT-2 keyrdi sama protokoll í vaksnum við feitt og týpu 2 diabetes og fann umleið 14,7% miðalvøttan vættataps við hægsta doys [7]. Atter: ein stór ávirkan, og atter merkjanliga minni enn í ikki-diabetiskum fólki. Meta-analysa, ið samanber tveir lyf í týpu 2 diabetes, setur tann relative raðfestingina á fastari grund [1][3].

Tirzepatide — miðalvøttan broyting eftir roynd og fólki
RannsóknFólkDoysVøtturMiðalvøttan broyting
SURMOUNT-1 [8]Feitt, uttan diabetes15 mg72 vikur≈ −20,9%
SURMOUNT-1 [8]Feitt, uttan diabetes5 mg72 vikur≈ −15%
SURMOUNT-2 [7]Feitt + týpu 2 diabetes15 mg72 vikur≈ −14,7%
SURMOUNT-5 [10]Feitt, hettar-til-hetta móti semaglutide≤15 mg72 vikurBetri enn semaglutide

Sláa semaglutide beint

Óbein samanberingar og veruleikafólk hava bent hesa leið í eina tíð [12], men royndin, ið avgreiddi tað, samanbar tey tveir lyf hettar-til-hetta við feitt doysum í sama fólki, og tirzepatide vann á miðalvøttan vættataps við einum stórum mun [10]. Í týpu 2 diabetes, hevði SURPASS-2 longu víst fyrimun yvir semaglutide 1 mg bæði á glykemiskum og vættataps endapunktum [9].

Úrslit, ið ikki snúgva seg um vættataps

Tvær serligar royndir fluttu tirzepatide út yvir feitt sum eina kategori.

  • Obstruktiv svefnapnø. Í vaksnum við miðal-til-alvarligum OSA og feitt, minnkaði tirzepatide apnoea-hypopnoea indeksin veruliga móti placebo [6]. Hetta er fyrsta farmakologiska viðgerð við randomiserðum vísum í einum tilburði, ið áður var stýrt næstan heilt við CPAP.
  • Hjartasvikt við varðveittari útstøttari fraktil. Í HFpEF við feitt — ein phenotypur við sera fáum effektivar viðgerðum — betraði tirzepatide úrslit móti placebo [4].
  • Hjartasjúkna. Ein serlig samanbering móti dulaglutide boðaði frá hjartasjúkna úrslitum í týpu 2 diabetes [11], ið leggur til tað fyrr nevnda forvalda meta-analysuna, ið fann einki signal um hjartasjúkna skaða.

Tað sæst eisini í evropeisku leiðbeiningunum um steatotiska lifrarsjúku saman við semaglutide [2].

Vanlig spurningar

Er Mounjaro tað sama sum Zepbound?
Sama mólekyl, men ymisk vørumerkjanøvn fyri sykursjúku- og feitleikaábendingarnar, í somum raðfylgju.
Er tirzepatide einfaldliga betri enn semaglutide?
Hvat viðvíkur miðal vektlætting í eini beinleiðis samanberandi feitleikaroynd, ja [10]. Hvat viðvíkur øllum øðrum — toleiliga hjá einum ávísum persóni, kostnaði, atkomu, og tann serliga fylgisjúkuna, ið tú viðgerð — er svarið einstakligt. Semaglutide hevur tað størra hjarta- og æðaúrslitagagnasettið.
Veldur GIP-parturin ta eyka vektlættingina?
Tað er tann sjónliga kandidaturin, men mekanismin er í roynd og veru óloystur. At blokera GIP eisini gevur vektlætting í summum modellum, sum er eitt av teimum undarligari opnu trupulleikunum í økinum.
Skal eg ná upp í 15 mg?
Nei. 5 mg-dosisin gav umleið 15% miðal vektlætting í SURMOUNT-1 [8], samanberiligt við tað besta semaglutide-úrsliti. Dosisin verður stillað eftir toleiliga.
Búgvað seng í einum trýfólks innanhýsis læknavøtt
玄史生 · CC0 · Wikimedia Commons

Tengt lesing

Evidensin fyri hesa síðu Ein stakkur bar, sum vísir samansetingina av 12 útgávunum, sum eru nevndar á hesi síðu eftir rannsóknartypum. 31011meta-analysis (3)randomised trial (10)review (1)other (1)
11 útgávur, 2021–2025. Tað er ein blanda við bæði royndum og samansetingum í henni, sum er støðan, har ein áheitan um orsøkir er rímilig. Kelda: egnu tilvísingalistin á hesi síðu, niðanfyri.

Viðmerkingar

Hver einasta tilvísing niðanfyri bendir til upprunaliga peer-reviewed skjalið á PubMed ella gjøgnum DOI. Einki her er ein staðfesting fyri læknaligt ráð.

  1. Efficacy and Safety of Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss Among Adults Without Diabetes : A Systematic Review of Randomized Controlled Trials Moiz A, Filion KB, Toutounchi H, et al. · Annals of internal medicine · 2025 · Systematic review DOIPubMed 39761578
  2. Subcutaneously administered tirzepatide vs semaglutide for adults with type 2 diabetes: a systematic review and network meta-analysis of randomised controlled trials Karagiannis T, Malandris K, Avgerinos I, et al. · Diabetologia · 2024 · Meta-analysis DOIPubMed 38613667Full text
  3. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary Diabetologia · 2024 · Clinical guideline DOIPubMed 38869512Full text
  4. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD) Journal of hepatology · 2024 · Clinical guideline DOIPubMed 38851997
  5. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis Yao H, Zhang A, Li D, et al. · BMJ (Clinical research ed.) · 2024 · Meta-analysis DOIPubMed 38286487Full text
  6. Risk of major adverse cardiovascular events and stroke associated with treatment with GLP-1 or the dual GIP/GLP-1 receptor agonist tirzepatide for type 2 diabetes: A systematic review and meta-analysis Stefanou MI, Theodorou A, Malhotra K, et al. · European stroke journal · 2024 · Meta-analysis DOIPubMed 38400569Full text
  7. Tirzepatide did not impact metabolic adaptation in people with obesity, but increased fat oxidation Ravussin E, Sanchez-Delgado G, Martin CK, et al. · Cell metabolism · 2025 · Randomised controlled trial DOIPubMed 40203836
  8. Efficacy and safety of tirzepatide in children and adolescents with type 2 diabetes (SURPASS-PEDS): a randomised, double-blind, placebo-controlled, phase 3 trial Hannon TS, Chao LC, Barrientos-Pérez M, et al. · Lancet (London, England) · 2025 · Randomised controlled trial DOIPubMed 40975112
  9. Efficacy and safety of once-weekly tirzepatide in Japanese patients with obesity disease (SURMOUNT-J): a multicentre, randomised, double-blind, placebo-controlled phase 3 trial Kadowaki T, Kiyosue A, Shingaki T, et al. · The lancet. Diabetes & endocrinology · 2025 · Randomised controlled trial DOIPubMed 40031941
  10. Tirzepatide and muscle composition changes in people with type 2 diabetes (SURPASS-3 MRI): a post-hoc analysis of a randomised, open-label, parallel-group, phase 3 trial Sattar N, Neeland IJ, Dahlqvist Leinhard O, et al. · The lancet. Diabetes & endocrinology · 2025 · Randomised controlled trial DOIPubMed 40318682
  11. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity Packer M, Zile MR, Kramer CM, et al. · The New England journal of medicine · 2025 · Randomised controlled trial DOIPubMed 39555826
  12. Tirzepatide for Obesity Treatment and Diabetes Prevention Jastreboff AM, le Roux CW, Stefanski A, et al. · The New England journal of medicine · 2025 · Randomised controlled trial DOIPubMed 39536238
  13. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight Look M, Dunn JP, Kushner RF, et al. · Diabetes, obesity & metabolism · 2025 · Randomised controlled trial DOIPubMed 39996356Full text
  14. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial Aronne LJ, Sattar N, Horn DB, et al. · JAMA · 2024 · Randomised controlled trial DOIPubMed 38078870Full text
  15. Tirzepatide for Weight Reduction in Chinese Adults With Obesity: The SURMOUNT-CN Randomized Clinical Trial Zhao L, Cheng Z, Lu Y, et al. · JAMA · 2024 · Randomised controlled trial DOIPubMed 38819983Full text
  16. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity Malhotra A, Grunstein RR, Fietze I, et al. · The New England journal of medicine · 2024 · Randomised controlled trial DOIPubMed 38912654Full text
  17. Tirzepatide vs Insulin Lispro Added to Basal Insulin in Type 2 Diabetes: The SURPASS-6 Randomized Clinical Trial Rosenstock J, Frías JP, Rodbard HW, et al. · JAMA · 2023 · Randomised controlled trial DOIPubMed 37786396Full text
  18. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial Garvey WT, Frias JP, Jastreboff AM, et al. · Lancet (London, England) · 2023 · Randomised controlled trial DOIPubMed 37385275
  19. Tirzepatide Reduces Appetite, Energy Intake, and Fat Mass in People With Type 2 Diabetes Heise T, DeVries JH, Urva S, et al. · Diabetes care · 2023 · Randomised controlled trial DOIPubMed 36857477Full text
  20. Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes: The SURPASS-5 Randomized Clinical Trial Dahl D, Onishi Y, Norwood P, et al. · JAMA · 2022 · Randomised controlled trial DOIPubMed 35133415Full text
  21. Tirzepatide Once Weekly for the Treatment of Obesity Jastreboff AM, Aronne LJ, Ahmad NN, et al. · The New England journal of medicine · 2022 · Randomised controlled trial DOIPubMed 35658024
  22. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial Rosenstock J, Wysham C, Frías JP, et al. · Lancet (London, England) · 2021 · Randomised controlled trial DOIPubMed 34186022
  23. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes Frías JP, Davies MJ, Rosenstock J, et al. · The New England journal of medicine · 2021 · Randomised controlled trial DOIPubMed 34170647
  24. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept Coskun T, Sloop KW, Loghin C, et al. · Molecular metabolism · 2018 · Randomised controlled trial DOIPubMed 30473097Full text
  25. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity Aronne LJ, Horn DB, le Roux CW, et al. · The New England journal of medicine · 2025 · Clinical trial DOIPubMed 40353578
  26. Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes Nicholls SJ, Pavo I, Bhatt DL, et al. · The New England journal of medicine · 2025 · Clinical trial DOIPubMed 41406444
  27. Tirzepatide, a dual GIP/GLP-1 receptor co-agonist for the treatment of type 2 diabetes with unmatched effectiveness regrading glycaemic control and body weight reduction Nauck MA, D'Alessio DA · Cardiovascular diabetology · 2022 · Review DOIPubMed 36050763Full text
  28. Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction Krüger N, Schneeweiss S, Fuse K, et al. · JAMA · 2025 · Journal article DOIPubMed 40886075Full text
  29. Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. · JAMA internal medicine · 2024 · Journal article DOIPubMed 38976257Full text
  30. New Drug: Tirzepatide (Mounjaro(™)) Gettman L · The Senior care pharmacist · 2023 · Journal article DOIPubMed 36751934

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