Phase 3 · Tirzepatide

SURPASS-6 trial results

A Randomized, Phase 3, Open-label Trial Comparing the Effect of the Addition of Tirzepatide Once Weekly Versus Insulin Lispro (U100) Three Times Daily in Participants With Type 2 Diabetes Inadequately Controlled on Insulin Glargine (U100) With or Without Metformin (SURPASS-6)

Change From Baseline in Hemoglobin A1c (HbA1c) (Pooled Doses of Tirzepatide 5 mg, 10 mg and 15 mg) (Percentage of HbA1c), Baseline, Week 52. Pooled 5 mg/10 mg/15 mg Tirzepatide: -2.26; Insulin Lispro: -1.16.

Participants
1,428
Status
completed
Completed
2022-11-01
Sponsor
Eli Lilly and Company

As posted on ClinicalTrials.gov (NCT04537923), updated at source Nov 2, 2023. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What SURPASS-6 measured first

Change From Baseline in Hemoglobin A1c (HbA1c) (Pooled Doses of Tirzepatide 5 mg, 10 mg and 15 mg)Percentage of HbA1c · Baseline, Week 52 · least squares mean
Pooled 5 mg/10 mg/15 mg Tirzepatiden=708Insulin Lispron=692
-2.26(0.048)-1.16(0.049)
Side effects by arm

Side effects in SURPASS-6

Percent of participants affected, Baseline up to week 56. The most common events the registry lists.

Event5 mg Tirzepatide10 mg Tirzepatide15 mg TirzepatideInsulin Lispro
Any serious event8.2%6.7%7.2%11.4%
Nausea13.6%20.6%25.8%1.1%
Decreased appetite8.2%11.8%16.9%0.1%
Diarrhoea11.9%15.1%11%2.4%
Vomiting4.5%8.8%12.7%0.6%
Covid-1911.5%8%8.9%10.2%
Dyspepsia6.2%11.3%11.4%0.6%
Constipation2.5%3.4%5.9%0.6%
Secondary outcomes

What else it measured

Change From Baseline in HbA1cPercentage of HbA1c · Baseline, Week 52 · least squares mean
5 mg Tirzepatiden=24110 mg Tirzepatiden=23415 mg Tirzepatiden=233Insulin Lispron=692
-2.05(0.082)-2.27(0.083)-2.46(0.084)-1.16(0.049)
Percentage of Participants With HbA1c Target Values <7.0%Percentage of participants · Week 52 · number
5 mg Tirzepatiden=24210 mg Tirzepatiden=23815 mg Tirzepatiden=236Insulin Lispron=708
61.0475.6479.8636.69
Change From Baseline in Body WeightKilograms (kg) · Baseline, Week 52 · least squares mean
5 mg Tirzepatiden=24110 mg Tirzepatiden=23415 mg Tirzepatiden=233Insulin Lispron=694
-6.9(0.37)-9.9(0.37)-12.0(0.38)3.8(0.22)
Change From Baseline in Fasting Serum Glucosemilligram per Deciliter (mg/dL) · Baseline, Week 52 · least squares mean
5 mg Tirzepatiden=24110 mg Tirzepatiden=23515 mg Tirzepatiden=233Insulin Lispron=694
-33.2(3.28)-43.0(3.32)-41.6(3.42)-10.0(1.99)
Change From Baseline in Daily Average 7-Point Self-Monitored Blood Glucose (SMBG) Valuesmg/dL/day · Baseline, Week 52 · least squares mean
5 mg Tirzepatiden=21910 mg Tirzepatiden=21015 mg Tirzepatiden=204Insulin Lispron=574
-56.7(1.80)-61.5(1.85)67.6(1.86)-55.8(1.13)
Percentage of Participants Who Achieved HbA1c Target Value of <7.0% Without HypoglycemiaPercentage of participants · Week 52 · number
5 mg Tirzepatiden=24110 mg Tirzepatiden=23415 mg Tirzepatiden=233Insulin Lispron=692
52.7070.0575.1213.41
Percentage of Participants Who Achieved Weight Loss ≥5%Percentage of participants · Week 52 · number
5 mg Tirzepatiden=24210 mg Tirzepatiden=23815 mg Tirzepatiden=236Insulin Lispron=708
64.1979.2183.156.34
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Physical Component Summary (PCS) Scorescore on a scale · Baseline, Week 52 · least squares mean
5 mg Tirzepatiden=22210 mg Tirzepatiden=21715 mg Tirzepatiden=199Insulin Lispron=599
1.0(0.46)1.7(0.46)1.7(0.48)-0.6(0.28)
Change From Baseline in 36-Item SF-36 Mental Component Summary (MCS) Scorescore on a scale · Baseline, Week 52 · least squares mean
5 mg Tirzepatiden=22210 mg Tirzepatiden=21715 mg Tirzepatiden=199Insulin Lispron=599
0.3(0.59)1.5(0.59)0.7(0.62)-1.3(0.36)
The trial

How SURPASS-6 was run

The purpose of this study is to compare the safety and efficacy of the study drug tirzepatide to insulin lispro (U100) three times a day in participants with type 2 diabetes that are already on insulin glargine (U100), with or without metformin.

  • 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.
  • Insulin Lispro: Insulin lispro 100 units per milliliter (U100) administered SC three times a day.
Who could join the trial

Inclusion Criteria: * Have been diagnosed with type 2 diabetes mellitus (T2DM) * Have HbA1c between ≥7.5% and ≤11% * Have been treated for at least 90 days prior to day of screening with once or twice daily basal insulin with or without stable dose of metformin ≥1500 mg/day and up to maximum approved dose per country specific approved label, sulfonylureas or dipeptidyl peptidase 4 inhibitors * Be of stable weight (± 5%) for at least 90 days * Have a BMI ≥23 kilograms per meter squared (kg/m²) and ≤45 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 macular edema or nonproliferative diabetic retinopathy requiring immediate or urgent treatment * Have disorders associated with slowed emptying of the stomach, have had any stomach surgeries for the purpose of weight loss, or are chronically taking drugs that directly affect gastrointestinal motility * 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 weight loss drugs, including over-the-counter medications during the last 3 months * Have an estimated glomerular filtration rate \<30 mL/minute/1.73 m² \[for participants on metformin, estimated glomerular filtration rate \<45 mL/min/1.73 m2 (or lower than the country-specific threshold for using the protocol-required dose of metformin per local label)\]

Published papers

Papers from SURPASS-6

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.