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Randomized controlled trial

SURMOUNT-2: tirzepatide (Zepbound) in type 2 diabetes

In people with type 2 diabetes and obesity, tirzepatide reduced weight by 12.8% with 10 mg and 14.7% with 15 mg at 72 weeks, compared with 3.2% on placebo.

Garvey WT et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. The Lancet, 2023. DOI: 10.1016/S0140-6736(23)01200-X

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Key facts

Drug
tirzepatide
Design
Randomized controlled trial
Participants
938
Duration
72 weeks
Funding
Eli Lilly
Population
938 adults with obesity (BMI of 27 or more) and type 2 diabetes; mean starting weight of 100.7 kg and HbA1c of 8.02%. Of the participants, 60% were Hispanic or Latino.
Primary outcome
Percentage change in body weight and proportion losing at least 5% at 72 weeks, tirzepatide 10 and 15 mg versus placebo.

What it found

Mean weight loss, % of starting weight · 72 weeks
  • Tirzepatide 10 mg weekly−12.8%
  • Tirzepatide 15 mg weekly−14.7%
  • Placebo−3.2%

Difference (Tirzepatide 10 mg weekly): −9.6 points vs placebo (95% CI, −11.1 to −8.1).

Difference (Tirzepatide 15 mg weekly): −11.6 points vs placebo (95% CI, −13.0 to −10.1).

Figures from the paperSee the results in a chart

In people with type 2 diabetes and obesity, tirzepatide reduced weight by 12.8% with 10 mg and 14.7% with 15 mg at 72 weeks, compared with 3.2% on placebo. The estimated differences were −9.6 percentage points (95% CI, −11.1 to −8.1) and −11.6 points (95% CI, −13.0 to −10.1). Between 79% and 83% of treated participants lost at least 5% of their weight, compared with 32% on placebo. The most common adverse effects were nausea, diarrhea and vomiting, mostly mild or moderate, with fewer than 5% stopping treatment because of them.

Limitations

Funded by Eli Lilly. Weight loss was smaller than in SURMOUNT-1, as usually happens in people with type 2 diabetes. No active comparator.

What it means for you

In people with type 2 diabetes and obesity, tirzepatide reduced weight by an average of 12.8% and 14.7% with 10 and 15 mg, less than in people without diabetes, as happens with other drugs. It helps set realistic expectations if you have diabetes. How it fits into your treatment is something to discuss with your doctor.

Further reading

Related trials

  • tirzepatide88 weeks

    SURMOUNT-4 (post hoc analysis)

    After switching from tirzepatide to placebo, the more weight people regained between week 36 and week 88, the more their cardiometabolic parameters worsened: waist circumference increased by 0.8 cm in those who regained less than 25% of the weight lost and by 14.7 cm in those who regained 75% or more.

  • tirzepatide112 weeks

    SURMOUNT-MAINTAIN

    At week 112, weight had changed by −21.9% on the maximum tolerated dose of tirzepatide, −16.6% on 5 mg and −9.9% on placebo.

  • tirzepatide72 weeks

    SURMOUNT-1 (body composition)

    At 72 weeks, weight changed by −21.3%, fat mass by −33.9% and lean mass by −10.9% with tirzepatide, compared with −5.3%, −8.2% and −2.6% on placebo.

  • tirzepatide and semaglutide72 weeks

    SURMOUNT-5

    At 72 weeks, weight fell by 20.2% with tirzepatide and 13.7% with semaglutide.

Sources

The original paper and the records consulted for this summary, with the date they were accessed.

  1. The Lancet.Garvey WT, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2). Lancet. 2023;402(10402):613-626.accessed .
  2. National Library of Medicine (PubMed).PubMed record PMID 37385275 (abstract).accessed .