Clinical Outcomes of Tirzepatide or GLP-1 Receptor Agonists in Individuals With Type 2 Diabetes
Main finding · All-cause mortalityResult — go to the resultAdjusted hazard ratio 0.58 95% CI 0.45–0.75Authors' conclusion
In this study, treatment with tirzepatide was associated with lower hazards of all-cause mortality, adverse cardiovascular events, acute kidney injury, and adverse kidney events compared with GLP-1 RA in patients with type 2 diabetes. These findings support the integration of tirzepatide into therapeutic strategies for this population.
Study context
- Population
- Adults ≥18 years with T2D initiating tirzepatide or GLP-1 RA between June 1, 2022, and June 30, 2023; without stage 5 CKD or kidney failure at baseline; without MI or ischemic or hemorrhagic stroke within 60 days of drug initiation
- Participants
- 14,834 vs 125,474
- Exposure
- Tirzepatide vs GLP-1 RA
- Tirzepatiden = 14,834
- GLP-1 RAn = 125,474reference
- Outcome
- All-cause mortality
- Follow-up
- Median (IQR) 10.5 (5.2-15.7) months
Methodological detailsTriNetX US Collaborative Network data, Cox proportional hazards regression models
- TriNetX US Collaborative Network data
- Cox proportional hazards regression models
Main finding
As reported in the abstract
median follow-up 10.5 months
Adjusted hazard ratio
0.58
95% CI 0.45–0.75
Events by group
Tirzepatidevs GLP-1 RA
aHR 0.58 (95% CI 0.45–0.75)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | |
|---|---|---|
| MACE | 0.80 (0.71–0.91) | |
| Composite of MACE and all-cause mortality | 0.76 (0.68–0.84) | |
| Kidney events | 0.52 (0.37–0.73) | |
| Acute kidney injury | 0.78 (0.70–0.88) | |
| Major adverse kidney events | 0.54 (0.44–0.67) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Treatment difference (percentage points) (95% CI) | |
|---|---|---|
| Change in HbA1c | −0.34 (−0.44 to −0.24) | |
| −0.6−0.4−0.200.2Difference, percentage points (linear scale) |
| Outcome | Treatment difference (kg) (95% CI) | |
|---|---|---|
| Change in body weight | −2.9 (−4.8 to −1.1) | |
| −6−4−202Difference, kg (linear scale) |
Subgroups
- Consistent results by eGFR, HbA1c, BMI, comedications and comorbidities (interaction test)
Original publication
Clinical Outcomes of Tirzepatide or GLP-1 Receptor Agonists in Individuals With Type 2 Diabetes. JAMA Netw Open. Published 1 August 2024. doi:10.
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