Oral Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Tirzepatide treatment and achieving weight reduction >5%, SBP reduction >5 mmHg and non-HDL cholesterol reduction >10%: A post hoc analysis from the SURMOUNT-1 3-year trial (128818)

Naveed Sattar 1 , Carel le Roux 2 , Mamas A. Mamas 3 , Hui Wang 4 , Casey J. Mast 4 , Georgios K. Dimitriadis 4 , Clare J. Lee 4 , Arian Plat 4 , Melissa Leung 5
  1. School of Cardiovascular and Metabolic Health , University of Glasgow, Glasgow, United Kingdom
  2. Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland and Diabetes Research Centre, Ulster University, Coleraine, UK
  3. School of Medicine, Keele University, Staffordshire, UK
  4. Eli Lilly and Company, Indianapolis, USA
  5. Liverpool Hospital, Sydney, NSW, Australia

Aims: This post-hoc analysis evaluated the proportion of participants who met the combined goal of weight reduction >5%, systolic blood pressure (SBP) reduction >5 mmHg and non-HDL cholesterol reduction >10% from baseline to Week-176 in SURMOUNT-1 3-year trial.

Methods: There were 568 participants with obesity and prediabetes who completed treatment with tirzepatide (n=454) or placebo (n=114) at Week-176 and had measures for all three outcomes (weight, blood pressure and lipids) or had any of the three measurements not meeting the threshold. Baseline characteristics were compared using ANOVA model for continuous data and Chi-square test for categorical data.

Results: Total 145 (25.5%) participants met the combined goal at Week-176. Participants meeting vs. not meeting the combined goal had higher mean SBP (130.0 vs. 124.4 mmHg), total cholesterol (203.6 vs. 186.1 mg/dL), non-HDL cholesterol (155.4 vs. 138.2 mg/dL), LDL cholesterol (123.0 vs, 108.7 mg/dL), and triglycerides (175.2 vs. 148.8 mg/dL) at baseline. Significantly more tirzepatide-treated participants (n=139, 30.6%) met the combined goal vs. placebo (n=6, 5.3%), p<0.0001.  Moreover, 94.2% (n=131) TZP participants who met the combined goal also had an HbA1c <5.7%, 41.0% (n=57) had a BMI ≤27 kg/m2 and 28.8% (n=40) had a WHtR <0.53. Of the six placebo participants who met the combined goal, all had HbA1c < 5.7%, 1 had a BMI ≤27 kg/m2 and 1 had a WHtR of <0.53.

Conclusion: Significantly more participants treated with tirzepatide as compared with placebo achieved a combined clinical goal of weight reduction >5%, SBP reduction >5 mmHg and non-HDL cholesterol reduction >10% vs. placebo. Most of the tirzepatide participants meeting the combined goal also achieved normoglycemia, over 1 in 3 participants met the BMI goal, and 1 in 4 met the WHtR goal, suggesting central adiposity reduction. Outcomes trials are ongoing to further evaluate the cardiometabolic impact of tirzepatide.