Tirzepatide for Type 2 Diabetes Mellitus

Horizon Scan reports provide brief summaries of information regarding new and emerging health technologies; Heath Technology Update articles typically focus on a single device or intervention. These technologies are identified through the CADTH Horizon Scanning Service as topics of potential interest to health care decision-makers in Canada. This Horizon Scan summarizes the available information regarding an emerging technology, tirzepatide, for the treatment of hyperglycemia in adults with type 2 diabetes. Type 2 diabetes (T2D) is a metabolic disease where blood glucose concentrations cannot be maintained at a normal level (hyperglycemia). Several antihyperglycemia drugs are currently available for the treatment of T2D including metformin, insulin secretagogues (meglitinides, sulfonylureas), dipeptidyl peptidase-4 (DPP4) inhibitors, sodium glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like polypeptide-1 (GLP-1) receptor agonists, thiazolidinediones, alpha-glucosidase inhibitors, and slow/fast-acting insulin analogues. Despite the number of drugs currently available to mitigate hyperglycemia, a significant unmet need for new therapeutics still exists. Tirzepatide (LY3298176; Eli Lilly Inc.) is a first in class dual glucagon-like polypeptide-1 (GLP-1) receptor and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist currently under development to treat hyperglycemia and obesity in individuals with T2D. To date, phase III clinical trials have been completed and several other trials are in progress to determine the efficacy of tirzepatide to reduce hyperglycemia (SURPASS studies) and obesity (SURMOUNT-2 study) in adults with T2D. This Horizon Scan bulletin focuses on the glycemic effect of tirzepatide in T2D. In summary, tirzepatide demonstrates efficacy in reducing mean glycated hemoglobin (A1C) compared to placebo, semaglutide, insulin degludec, and insulin glargine. Studies investigating the possible effect of tirzepatide on cardiovascular outcomes are currently ongoing.