GLP-1 Evidence

Mediċina

Tirzepatide: x'juru t-testi

Tirzepatide prodotta l-akbar telf ta' piż medju qatt irreġistrat għal mediċina f'test ta' obezità randomizzat. Huwa wkoll l-uniku li għandu r-riżultati mhux relatati mal-piż l-aktar interessanti.

Aġġornat 3 min read 30 ċitazzjonijiet Saħħa tal-evidenza 5/5

Faċċata ta' apotheka Ġermaniża vista mill-ġenb tat-triq
muckelfloh · CC BY 3.0 · Wikimedia Commons

SURMOUNT-1: l-akbar magnitudni ta' effett fil-qasam

SURMOUNT-1 randomizzat adulti b'obeżità u mingħajr dijabete għal tirzepatide 5, 10 jew 15 mg kull ġimgħa, jew placebo, għal 72 ġimgħa [8]. Il-bidla medja fil-piż fil-ogħla doża kienet madwar −20.9%, bil-doża ta' 5 mg diġà madwar −15% — ifisser li l doża tirzepatide l-inqas matul il-perjodu ta' ttestjar kienet qrib ir-riżultat l-aħjar ta' semaglutide. Aktar minn nofs il-parteċipanti fil-dożi ogħla tilfu mill-inqas 20% tal-piż tal-ġisem.

Il-kontinwazzjoni ta' dak il-programm estendiet il-folol u rrappurtat dwar il-prevenzjoni tad-dijabete flimkien ma' tnaqqis sostenut fil-piż [5], li huwa importanti għax iċċaqlaq il-punt ta' tmiem minn numru fuq skala għal avveniment kliniku.

Efficacy tat-telf ta' piż

Il-penali tad-dijabete tapplika hawnhekk ukoll

SURMOUNT-2 għamel l-istess protokoll f'adulti b'obeżità u dijabete tat-tip 2 u sab madwar 14.7% telf medju ta' piż fil-ogħla doża [7]. Mill-ġdid: effett kbir, u mill-ġdid inqas notarjament minn fil-popolazzjoni mingħajr dijabete. Meta-analiżi li tqabbel it-tnejn mediċini f'dijabete tat-tip 2 tpoġġi l-ordni relattiva fuq art aktar soda [1][3].

Tirzepatide — bidla medja fil-piż skont it-testi u l-popolazzjoni
ProvaPopolazzjoniDożaDaqsTibdil medju fil-piż
SURMOUNT-1 [8]Obeżità, mingħajr dijabete15 mg72 ġimgħa≈ −20.9%
SURMOUNT-1 [8]Obeżità, mingħajr dijabete5 mg72 ġimgħa≈ −15%
SURMOUNT-2 [7]Obeżità + dijabete tat-tip 215 mg72 ġimgħa≈ −14.7%
SURMOUNT-5 [10]Obeżità, kontra semaglutide≤15 mg72 ġimgħaSuperjuri għal semaglutide

Rebħet semaglutide direttament

Komparazzjonijiet indiretti u koorti reali kienu jindika din it-triq għal żmien [12], iżda t-test li stabbilixxa dan komparat it-tnejn mediċini f'kontra f'dożi ta' obezità fil-istess popolazzjoni, u tirzepatide rebħet fuq it-telf medju tal-piż b'margni sostanzjali [10]. F'dijabete tat-tip 2, SURPASS-2 diġà wera superjuri fuq semaglutide 1 mg fuq it-tmiem ta' glikemija u piż [9].

Ir-riżultati li mhumiex dwar il-piż

Tnejn testi dedikati ħallew tirzepatide lil hinn mill-obezità bħala kategorija.

  • Apnoea tal-ħolqien ostruzzjoni. F'adulti b'OSA moderata għal severa u obeżità, tirzepatide naqqas l-indice ta' apnoea-hypopnoea b'mod sostanzjali kontra placebo [6]. Dan huwa l-ewwel trattament farmaċewtiku b'evidenza randomizzata f'kundizzjoni li qabel kienet immaniġġjata kważi esklussivament bil-CPAP.
  • Insuffiċjenza tal-qalb bil-frazzjoni ta' eċċentriċi preservata. F'HFpEF b'obeżità — fenotip b'ħafna ftit trattamenti effettivi — tirzepatide ittejjeb ir-riżultati kontra placebo [4].
  • Avvenimenti kardjovaskulari. Komparazzjoni dedikata kontra dulaglutide rrappurtat riżultati kardjovaskulari f'dijabete tat-tip 2 [11], li żiedet mal-meta-analiżi pre-specifikata li sabet l-ebda sinjal ta' ħsara kardjovaskulari.

Huwa jidher ukoll fil-gwida Ewropea dwar mard tal-fwied steatosis flimkien ma' semaglutide [2].

Mistoqsijiet komuni

Mounjaro huwa l-istess bħal Zepbound?
L-istess molekula, ismijiet kummerċjali differenti għall-indikazzjonijiet rispettivi tad-dijabete u l-obeżità.
It-tirzepatide sempliċement aħjar mis-semaglutide?
Fuq it-telf medju tal-piż f'prova ta' obeżità head-to-head, iva [10]. Fuq kull ħaġa oħra — it-tollerabbiltà għal persuna partikolari, l-ispiża, id-disponibbiltà, u l-komorbidità speċifika li qed tiġi trattata — it-tweġiba hija individwali. Is-semaglutide għandu s-sett ta' dejta kardjovaskulari akbar.
Il-komponent GIP jikkawża t-telf ta' piż addizzjonali?
Huwa l-kandidat ovvju, iżda l-mekkaniżmu huwa ġenwinament mhux solvut. L-imblukkar tal-GIP jipproduċi wkoll telf ta' piż f'xi mudelli, li huwa wieħed mill-aktar problemi miftuħa stramba fil-qasam.
Irrid nilħaq il-15 mg?
Le. Id-doża ta' 5 mg ipproduċiet madwar 15% telf medju f'SURMOUNT-1 [8], komparabbli mal-aħjar riżultat tas-semaglutide. Id-doża tiġi titrata skont it-tollerabbiltà.
Sodda magħmula f'kamra ta' ward ta' mediċina interna għal tliet persuni
玄史生 · CC0 · Wikimedia Commons

Qari relatat

Il-provi li hemm wara din il-paġna Bar imwaħħal li juri l-kompożizzjoni tal-12 pubblikazzjoni ċċitata f'din il-paġna skont it-tip ta' studju. 31011meta-analysis (3)randomised trial (10)review (1)other (1)
11 pubblikazzjonijiet, 2021–2025. Dan huwa miks li fih kemm provi kif ukoll sintesi, li huwa l-pożizzjoni minn fejn talba dwar il-kawża hija raġonevoli. Sors: il-lista ta' ċitazzjonijiet ta' din il-paġna, hawn taħt.

Referenzi

Kull ċitazzjoni hawn taħt tgħaqqad mal-record oriġinali peer-reviewed fuq PubMed jew permezz ta' DOI. Xejn hawnhekk m'għandux ikun sostitut għal parir mediku.

  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

Din il-paġna ġiet tradotta awtomatikament mill-Ingliż. Il-citazzjonijiet u n-numri mhumiex mibdula. Aqra l-original Ingliż jekk xi ħaġa taqra b'mod stramb. Aqra l-original Ingliż