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HEALTHSPAN
MEDICAL

  • Alexander Olaussen

Tirzepatide: GLP-1 Agonist

Background:

  • Tirzepatide is a relatively new medication that has been making waves in the world of diabetes management and metabolic health.

  • Tirzepatide is a once-weekly injectable medication developed by Eli Lilly and Company.

  • It belongs to a class of drugs known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs).

  • This class of medications has gained attention for their ability to improve blood sugar control and promote weight loss.

Evidence-Based Benefits:

1. Improved Glycemic Control:

Clinical trials have demonstrated that Tirzepatide significantly lowers blood sugar levels in people with type 2 diabetes. Its mechanism of action involves enhancing the release of insulin and suppressing the release of glucagon.


2. Weight Loss:

One of the intriguing aspects of Tirzepatide is its potential to lead to substantial weight loss. In clinical trials, patients experienced significant reductions in body weight, making it a promising option for those with obesity or overweight individuals with diabetes.


3. Cardiovascular Benefits:

Some evidence suggests that Tirzepatide may have cardiovascular benefits beyond just glycemic control. It has been associated with a reduction in cardiovascular events in certain studies, although more research is needed to confirm these effects.


Downsides

1. Long-Term Safety unknown:

As with any new medication, long-term safety data are crucial. While short-term studies have shown promising results, ongoing monitoring and research are needed to understand any potential side effects or risks associated with Tirzepatide.


2. Broader Applications:

While initially developed for diabetes management, there is interest in exploring Tirzepatide's potential in other areas, such as obesity treatment and non-alcoholic fatty liver disease (NAFLD). Further studies will help clarify its role in these conditions.



The evidence base:

Systematic Reviews / Meta-analyses

  • Karagiannis, T., Avgerinos, I., Liakos, A., Del Prato, S., Matthews, D. R., Tsapas, A., & Bekiari, E. (2022). Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: A systematic review and meta-analysis. Diabetologia, 65(8), 1251–1261. https://doi.org/10.1007/s00125-022-05715-4

  • Conclusion: A dose-dependent superiority on glycaemic efficacy and body weight reduction was evident with tirzepatide vs placebo, GLP-1 RAs and basal insulin. Tirzepatide did not increase the odds of hypoglycaemia but was associated with increased incidence of gastrointestinal adverse events. Study limitations include presence of statistical heterogeneity in the meta-analyses for change in HbA1c and body weight, assessment of risk of bias solely for the primary outcome, and generalisation of findings mainly to individuals who are overweight or obese and already on metformin-based background therapy.

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