Eli Lilly's dual GIP/GLP-1 agonist tirzepatide has demonstrated remarkable efficacy in both preventing type 2 diabetes progression and achieving faster therapeutic targets compared to existing treatments, according to new clinical data that could reshape diabetes management strategies.
Breakthrough Prevention Results in Pre-Diabetes
The SURMOUNT-1 trial, a comprehensive 176-week study spanning three years, revealed that tirzepatide achieved a 94% reduction in the risk of progression to type 2 diabetes in overweight and obese adults with pre-diabetes. This finding emerged from a sub-population analysis of patients who received once-weekly injections of tirzepatide at doses of 5, 10, and 15 mg compared to placebo.
The weight loss results were equally impressive, with patients on the highest 15 mg dose losing an average of 22.9% of their body weight over the three-year period, while placebo recipients shed only 2.1%. These results underpinned tirzepatide's approval for obesity treatment last year.
"Obesity is a chronic disease that puts nearly 900 million adults worldwide at an increased risk of other complications, such as type 2 diabetes," said Jeff Emmick, head of product development at Lilly. The data reinforces "the potential clinical benefits of long-term therapy for people living with obesity and pre-diabetes."
Accelerated Time to Therapeutic Goals
A separate comparative study conducted by researchers at East and North Hertfordshire NHS Trust revealed tirzepatide's superior speed in achieving critical diabetes management milestones. The research compared tirzepatide with semaglutide and insulin degludec in patients also following healthy diets and taking oral diabetes medications.
Patients taking tirzepatide reached their first blood sugar goal of HbA1c below 7% within eight weeks on average, regardless of dose (5, 10, or 15 mg). In contrast, those receiving semaglutide or insulin degludec required approximately 12 weeks to achieve the same target.
For the more stringent HbA1c goal of 6.5% or lower, tirzepatide demonstrated even greater advantages. Patients reached this target in about 12 weeks, while semaglutide required 16 weeks and insulin degludec needed 24 weeks.
Weight Loss Timeline Advantages
The weight management benefits of tirzepatide also manifested more rapidly than competing treatments. Participants receiving the higher doses of tirzepatide (10 mg and 15 mg) achieved at least 5% body weight loss within 12 weeks. Semaglutide patients required double the time—approximately 24 weeks—to reach the same weight reduction milestone.
Dr. Adie Viljoen, who led the comparative study, emphasized that faster improvements in blood sugar and weight control can enhance patient motivation and treatment adherence. The 5% body weight loss threshold is clinically significant, as it can lead to improved blood sugar control and reduced cardiovascular risk in diabetes patients.
Market Implications and Current Performance
The potential approval of tirzepatide for pre-diabetes treatment could unlock a substantial market opportunity. According to the US Centers for Disease Control and Prevention, approximately 98 million Americans—one in three adults—have pre-diabetes, with two-thirds progressing to full diabetes.
Tirzepatide is currently marketed as Mounjaro for type 2 diabetes and Zepbound for obesity, generating nearly $5 billion and $1.5 billion respectively in Lilly's first half-year revenues of just over $20 billion. The drug's growth trajectory has begun outpacing Novo Nordisk's competing GLP-1 agonist semaglutide, marketed as Ozempic and Wegovy.
Lilly plans to present detailed SURMOUNT-1 results at ObesityWeek 2024, scheduled for November 3-6 in San Antonio, Texas, where the full scope of the pre-diabetes prevention data will be unveiled to the medical community.
