Efficacy of tirzepatide versus semaglutide in achieving therapeutic targets in type 2 diabetes: a post hoc analysis of the SURPASS-2 Trial.

Glucagon-like peptide-1 (GLP-1)-based therapies improve all these variables but whether the dual GLP-1 / glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide is superior to semaglutide in attaining therapeutic targets remains unclear.

基于胰高血糖素样肽-1（GLP-1）的治疗改善了所有这些变量，但双靶点GLP-1/葡萄糖依赖性胰岛素促进多肽（GIP）激动剂tirzepatide是否优于semaglutide以达到治疗目标尚不明确。

Methods

We performed a post hoc analysis of the SURPASS-2 trial, a randomised phase 3 study including 1879 adults with type 2 diabetes.

我们对SURPASS-2试验进行了事后分析，这是一项包含1879名2型糖尿病成人的随机III期研究。

Participants were randomised to receive tirzepatide (5, 10 or 15 mg) or semaglutide (1 mg).

参与者被随机分配接受tirzepatide（5、10或15毫克）或semaglutide（1毫克）。

In this analysis, we compared the effects of tirzepatide vs semaglutide on the attainment of standard (HbA1c <53 mmol/mol [7%], BP <140/90 mmHg, LDL-cholesterol <1.8 mmol/l, >10% weight loss) and intensive (HbA1c <48 mmol/mol [6.5%], BP <130/80 mmHg, LDL-cholesterol <1.4 mmol/l , >15% weight loss) therapeutic targets at 40 weeks.

在这项分析中，我们比较了tirzepatide与semaglutide对达到标准（HbA1c <53 mmol/mol [7%]，血压<140/90 mmHg，LDL胆固醇<1.8 mmol/l，体重减轻>10%）和强化（HbA1c <48 mmol/mol [6.5%]，血压<130/80 mmHg，LDL胆固醇<1.4 mmol/l，体重减轻>15%）治疗目标在40周时的影响。

Results

In the SURPASS-2 trial, at baseline, 19% of participants were on target for attaining no standard goals, 59% for one goal and 21% for two or more goals.

在SURPASS-2试验中，基线时，19%的参与者达到了无标准目标的标准，59%达到了一个目标，21%达到了两个或更多目标。

For intensive therapeutic targets, 58% of participants were on target for attaining zero goals, 38% for one goal and 4% for two goals.

对于密集治疗目标，58%的参与者达到了零个目标，38%达到了一个目标，4%达到了两个目标。

All doses of tirzepatide increased the number of achieved standard and intensive targets compared with semaglutide.

所有剂量的tirzepatide与semaglutide相比，增加了达到标准和密集治疗目标的数量。

For standard targets, 34% of participants treated with semaglutide met three or more targets, compared with 42%, 53% and 57% with tirzepatide 5, 10 and 15 mg, respectively.

对于标准目标，接受司美格鲁肽治疗的参与者中有34%达到三个或更多目标，而接受5mg、10mg和15mg曲唑肽治疗的参与者分别有42%、53%和57%达到三个或更多目标。

For intensive targets, 8% of participants treated with semaglutide met three or more targets, vs 15%, 20% and 29% with tirzepatide.

对于强化目标，接受司美格鲁肽治疗的参与者中有8%达到三个或更多目标，而接受曲唑肽治疗的参与者分别有15%、20%和29%达到三个或更多目标。

Regarding specific therapeutic goals, tirzepatide increased the odds of achieving standard and intensive targets for HbA1c (HbA1c <53 mmol/mol [7%], OR 1.50 [95% CI 1.12, 2.00]; HbA1c <48 mmol/mol [6.5%], OR 1.88 [95%CI 1.49, 2.36]) and weight loss (weight loss >10%, OR 2.72 [95% CI 2.14, 3.47]; weight loss >15%, OR 3.86 [95% CI 2.69, 5.55]) and the intensive target for BP (OR 1.45 [95% CI 1.17, 1.81]).

关于特定的治疗目标，tirzepatide提高了达到HbA1c标准和强化目标的几率（HbA1c <53 mmol/mol [7%]，OR 1.50 [95% CI 1.12, 2.00]；HbA1c <48 mmol/mol [6.5%]，OR 1.88 [95%CI 1.49, 2.36]）以及减重目标（减重>10%，OR 2.72 [95% CI 2.14, 3.47]；减重>15%，OR 3.86 [95% CI 2.69, 5.55]）和血压强化目标（OR 1.45 [95% CI 1.17, 1.81]）。

conclusions/interpretation

Tirzepatide improves therapeutic target attainment compared with semaglutide in type 2 diabetes.

与semaglutide相比，tirzepatide在2型糖尿病中提高了治疗目标的达成率。

Longer trials are needed to confirm benefits on long-term prognosis.

需要更长期的试验来确认对长期预后的好处。

data_availability

Data for this post hoc analysis was accessed through the Vivli (Center for Global Clinical Research Data) platform ( https://vivli.org ) with the Vivli ID 00009964.

本次事后分析的数据是通过Vivli（全球临床研究数据中心）平台（https://vivli.org）获取的，Vivli ID为00009964。