Phase 3 · Semaglutide

SURPASS-2 trial results

A Phase 3, Randomized, Open-Label Trial Comparing Efficacy and Safety of Tirzepatide Versus Semaglutide Once Weekly as Add-on Therapy to Metformin in Patients With Type 2 Diabetes

Change From Baseline in Hemoglobin A1c (HbA1c) (10 mg and 15 mg) (Percentage of HbA1c), Baseline, Week 40. 10 mg Tirzepatide: -2.37; 15 mg Tirzepatide: -2.46; 1 mg Semaglutide: -1.86.

Participants
1,879
Status
completed
Completed
2021-02-15
Sponsor
Eli Lilly and Company

As posted on ClinicalTrials.gov (NCT03987919), updated at source Feb 14, 2022. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What SURPASS-2 measured first

Change From Baseline in Hemoglobin A1c (HbA1c) (10 mg and 15 mg)Percentage of HbA1c · Baseline, Week 40 · least squares mean
10 mg Tirzepatiden=45915 mg Tirzepatiden=4641 mg Semaglutiden=461
-2.37(0.048)-2.46(0.048)-1.86(0.048)
Side effects by arm

Side effects in SURPASS-2

Percent of participants affected, Baseline, Safety follow-up (44 Weeks). The most common events the registry lists.

Event5 mg Tirzepatide10 mg Tirzepatide15 mg Tirzepatide1 mg Semaglutide
Any serious event7%5.3%5.7%2.8%
Nausea17.4%19.2%22.1%17.9%
Diarrhoea13.2%16.4%13.8%11.5%
Vomiting5.7%8.3%9.8%8.3%
Dyspepsia7.2%6.2%9.1%6.6%
Decreased appetite7.4%7.2%8.9%5.3%
Constipation6.6%4.5%4.5%5.8%
Abdominal pain3%4.3%5.1%5.1%
Secondary outcomes

What else it measured

Change From Baseline in HbA1c (5 mg)Percentage of HbA1c · Baseline, Week 40 · least squares mean
5 mg Tirzepatiden=4611 mg Semaglutiden=461
-2.09(0.047)-1.86(0.048)
Change From Baseline in Body WeightKilograms (kg) · Baseline, Week 40 · least squares mean
5 mg Tirzepatiden=46110 mg Tirzepatiden=45915 mg Tirzepatiden=4641 mg Semaglutiden=462
-7.8(0.33)-10.3(0.34)-12.4(0.34)-6.2(0.33)
Percentage of Participants Achieving an HbA1c Target Value of <7%Percentage of Participants · Week 40 · number
5 mg Tirzepatiden=46110 mg Tirzepatiden=45915 mg Tirzepatiden=4641 mg Semaglutiden=461
85.4788.8992.2481.13
Change From Baseline in Fasting Serum Glucose (FSG)milligram per Deciliter (mg/dL) · Baseline, Week 40 · least squares mean
5 mg Tirzepatiden=46110 mg Tirzepatiden=45815 mg Tirzepatiden=4641 mg Semaglutiden=459
-56.0(1.57)-61.6(1.60)-63.4(1.59)-48.6(1.58)
Mean Change From Baseline in Daily Average 7-Point Self-Monitored Blood Glucose (SMBG) Valuesmg/dL · Baseline, Week 40 · least squares mean
5 mg Tirzepatiden=42410 mg Tirzepatiden=41215 mg Tirzepatiden=4131 mg Semaglutiden=414
-65.4(1.04)-70.6(1.05)-74.3(1.05)-61.4(1.04)
Percentage of Participants Who Achieved Weight Loss ≥5%Percentage of Participants · Week 40 · number
5 mg Tirzepatiden=46110 mg Tirzepatiden=45915 mg Tirzepatiden=4641 mg Semaglutiden=462
68.5582.3586.2158.44
Diabetes Treatment Satisfaction as Measured by the Diabetes Treatment Satisfaction Questionnaire, Change Version (DTSQc) Hyperglycemia, Hypoglycemia and Total ScoreUnits on a Scale · Baseline, Week 40 · least squares mean
Measure5 mg Tirzepatiden=41910 mg Tirzepatiden=39915 mg Tirzepatiden=3981 mg Semaglutiden=412
Hyperglycemia-1.3(0.10)-1.4(0.10)-1.5(0.10)-1.1(0.10)
Hypoglycemia-0.7(0.10)-0.7(0.10)-0.8(0.10)-0.7(0.10)
Total Score15.7(0.18)15.6(0.19)16.1(0.19)15.8(0.19)
Rate of Hypoglycemia With Blood Glucose <54 Milligram/Deciliter (mg/dL) [<3.0 Millimole/Liter (mmol/L)] or Severe HypoglycemiaEpisodes/participant/365.25 days · Baseline through Safety Follow-Up (Up to Week 44) · mean
5 mg Tirzepatiden=47010 mg Tirzepatiden=46915 mg Tirzepatiden=4701 mg Semaglutiden=469
0.0102(0.00423)0.0046(0.00488)0.0202(0.00840)0.0046(0.00340)
Percentage of Participants Achieving an HbA1c Target Value of <5.7%Percentage of Participants · Week 40 · number
5 mg Tirzepatiden=46110 mg Tirzepatiden=45915 mg Tirzepatiden=4641 mg Semaglutiden=461
29.2844.6650.8619.74
The trial

How SURPASS-2 was run

The reason for this study is to compare the effect of the study drug tirzepatide to semaglutide on blood sugar levels in participants with type 2 diabetes. The study will last approximately 47 weeks and may include about 12 visits.

  • 5 mg Tirzepatide: 5 milligrams (mg) tirzepatide administered subcutaneously (SC) once a week.
  • 10 mg Tirzepatide: 10 mg tirzepatide administered SC once a week.
  • 15 mg Tirzepatide: 15 mg tirzepatide administered SC once a week.
  • 1 mg Semaglutide: 1 mg semaglutide administered SC once a week.
Who could join the trial

Inclusion Criteria: * Have been diagnosed with type 2 diabetes mellitus (T2DM) * Have HbA1c between ≥7.0% and ≤10.5% * Be on stable treatment with unchanged dose of metformin \>1500 mg/day for at least 3 months prior to screening * Be of stable weight (±5%) for at least 3 months before screening * Have a body mass index (BMI) ≥25 kilograms per meter squared (kg/m²) at screening Exclusion Criteria: * Have type 1 diabetes mellitus * Have had chronic or acute pancreatitis any time prior to study entry * Have proliferative diabetic retinopathy or diabetic maculopathy or nonproliferative diabetic retinopathy requiring acute treatment * Have disorders associated with slowed emptying of the stomach, or have had any stomach surgeries for the purpose of weight loss * Have acute or chronic hepatitis, signs and symptoms of any other liver disease, or blood alanine transaminase (ALT) enzyme level \>3.0 times the upper limit of normal (ULN) for the reference range, as determined by the central laboratory. Participants with nonalcoholic fatty liver disease (NAFLD) are eligible for participation in this trial only if there ALT level is ≤3.0 the ULN for the reference range * Have an estimated glomerular filtration rate \<45 milliliters/minute/1.73 m² (or lower than the country specific threshold for using the protocol required dose of metformin per local label) * Have had a heart attack, stroke, or hospitalization for congestive heart failure in the past 2 months * Have a personal or family history of medullary thyroid carcinoma or personal history of multiple endocrine neoplasia syndrome type 2 * Have been taking any other diabetes medicines other than metformin during the last 3 months * Have been taking weight loss drugs, including over-the-counter medications during the last 3 months

Published papers

Papers from SURPASS-2

Trial averages do not predict what one person will experience. Results are shown as the registry posts them, without interpretation.

GLPcompare is an informational data platform, not a medical provider or pharmacy. Nothing here is medical advice, a diagnosis, or a recommendation to start, stop, or change any treatment. Data is aggregated from public sources and can be incomplete or out of date. Always confirm with a licensed clinician and the current FDA label.