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SURPASS trial programme (revision 4)

Old revision·08:48, 13 Aug 2024·LOD_Lorcan

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SURPASS trial programme
DrugTirzepatide 5, 10 and 15 mg weekly
IndicationType 2 diabetes
Notable memberSURPASS-2, head-to-head with semaglutide
Topic infobox · conventions

The SURPASS trial programme is the phase 3 series that established tirzepatide for type 2 diabetes. Its trials compared tirzepatide at 5, 10 and 15 mg weekly against placebo, semaglutide 1 mg, insulin degludec, insulin glargine and dulaglutide.[1]

Glycated-haemoglobin reductions across the programme were larger than those reported for any comparator, reaching about 2.0–2.6 percentage points at the higher doses depending on trial and baseline. Weight reduction accompanied them at every dose.[1]

Constituent trials

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TrialComparatorNotes
SURPASS-1PlaceboMonotherapy in drug-naive participants
SURPASS-2Semaglutide 1 mgOpen-label head-to-head
SURPASS-3Insulin degludecAdded to metformin ± SGLT2 inhibitor
SURPASS-4Insulin glargineHigh cardiovascular risk population
SURPASS-5PlaceboAdded to insulin glargine
SURPASS-CVOTDulaglutideCardiovascular outcomes, active comparator

SURPASS-CVOT is unusual among cardiovascular outcome trials in using an active comparator with an established benefit rather than placebo, which changes what a non-inferiority result means: non-inferiority to an agent that itself reduced events is a stronger statement than non-inferiority to placebo.[1]

References

  1. ^ a b c Frías JP, Davies MJ, Rosenstock J, et al. "Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes." New England Journal of Medicine 385(6):503–515 (2021). DOI:10.1056/NEJMoa2107519. PMID 34170647.