Page 45 - Read Online

Page 6 of 19 Kalloo et al. Metab Target Organ Damage 2023;3:7 https://dx.doi.org/10.20517/mtod.2022.26

estimated treatment difference, -
1.9 kg, -3.6 kg, and -5.5 kg,
respectively; P < 0.001 for all
comparisons)
SURPASS 3 GIP/GLP1 RA Assessing the efficacy and safety Non-inferiority of tirzepatide Reductions in HbA1c at week 52
Tirzepatide of tirzepatide versus titrated 10 mg or 15 mg, or both, versus were 1.93% (SE 0.05) for
insulin degludec in people with insulin degludec in mean tirzepatide 5 mg, 2.20% (0.05) for
T2DM inadequately controlled by change from baseline in HbA1c tirzepatide 10 mg, and 2.37%
metformin with or without SGLT2 at week 52 (0.05) for tirzepatide 15 mg, and
inhibitors 1.34% (0.05) for insulin degludec.
The non-inferiority margin of 0.3%
was met.
The estimated treatment
difference (ETD) versus insulin
degludec ranged from -0.59% to -
1.04% for tirzepatide (P < 0.0001
for all tirzepatide doses)
SURPASS 4 GIP/GLP1 RA Assessing efficacy and safety Non-inferiority (0.3% non- Mean HbA1c changes with
Tirzepatide (especially CV safety) of inferiority boundary) of tirzepatide were -2.43% (SD 0.05)
tirzepatide versus insulin glargine tirzepatide 10 mg or 15 mg, or with 10 mg and -2.58% (0.05) with
in adults with T2DM and high CV both, versus glargine in HbA1c 15 mg, versus -1.44% (0.03) with
risk inadequately controlled on oral change from baseline to 52 glargine.
glucose-lowering medications weeks The estimated treatment
difference versus glargine was -
0.99% (multiplicity adjusted
97.5%CI: -1.13 to -0.86) for
tirzepatide 10 mg and -1.14% (-1.28
to -1.00) for 15 mg
SURPASS GIP/GLP1 RA Assessing the efficacy and safety Time to the first occurrence of Awaited
CVOT Tirzepatide of tirzepatide to dulaglutide in death from cardiovascular
participants with type 2 diabetes (CV) causes, myocardial
and increased cardiovascular risk infarction (MI), or stroke
(MACE-3)
ESSENCE GLP1-RA Semaglutide Assessing the safety and efficacy Resolution of NASH with no The percentage of patients in
of semaglutide in biopsy-proven worsening of fibrosis whom NASH resolution was
NASH and liver fibrosis achieved with no worsening of
fibrosis was 40% in the 0.1 -mg
group, 36% in the 0.2 -mg group,
59% in the 0.4 -mg group, and
17% in the placebo group (P <
0.001 for semaglutide 0.4 mg vs.
placebo).
An improvement in fibrosis stage
occurred in 43% of the patients in
the 0.4 -mg group and in 33% of
the patients in the placebo group (
P = 0.48)
SYNERGY- GIP/GLP1 RA Assessing the safety and Percentage of participants with Awaited
NASH Tirzepatide effectivity of tirzepatide as a an absence of NASH with no
treatment for Nonalcoholic worsening of fibrosis on liver
Steatohepatitis (NASH) histology

cardiovascular outcomes never fully abated, although the data from the CAROLINA trial which compared
linagliptin with glimepiride and showed no differences in CV outcomes may reassure many with regards to
sulphonylureas . The role of sulphonylureas in the current landscape perhaps focuses on the management
[7]
of hyperglycaemia, where insulin is not deemed necessary or where quick glucose lowering is required,
[8,9]
including in some instances of steroid-induced hyperglycaemia . From a global perspective, the low cost
and efficacy in terms of glucose lowering still suggest a role in economies where cost is a key consideration
[10]
and the role of sulphonylureas in maturity-onset diabetes of the young (MODY) remains .
Thiazolidinediones, specifically pioglitazone, may not be utilized as often as they once were, in part due to
alternative options with lesser side effect profiles, but there are still some considerations for their use in type
2 diabetes. Their effect on those with insulin resistance remains of note, with recent trials such as the
TriMaster study identifying that in patients with BMI over 30 kg/m , pioglitazone offered greater Hba1c
2