Tirzepatide Tied to Lower Risk for Death, Adverse CV and Kidney Outcomes vs GLP-1s: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in JAMA Network Open Diabetes and Endocrinology that examined the association of tirzepatide with mortality and adverse cardiovascular and kidney outcomes compared with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes (T2D).

The study

Investigators searched the TriNetX database for adults aged 18 years and older with T2D who had been prescribed tirzepatide or a GLP1-RA between June 1, 2022, and June 30, 2023. The study protocol called for exclusion of any potential participant with stage 5 kidney disease, end stage kidney disease, or receiving dialysis at baseline.

Of the final 140 308 participants (mean age 56 years; 55.3% women) 14 384 were treated with tirzepatide and 125 474 with GLP-1RA. All participants were followed for a maximum of 21 months or until data analysis on May 2, 2024.

The primary outcome was all-cause mortality, and secondary outcomes included major adverse cardiovascular events (MACEs), the composite of MACEs and all-cause mortality, kidney events, acute kidney injury, and major adverse kidney events (MAKE).

The findings

Over an average follow-up period of 10.5 months study participants treated with tirzepatide vs GLP1-RAs had a statistically significant:

• 42% reduced relative risk for all-cause mortality

• 46% lower risk of MAKE

• 20% lower risk of MACE

• 24% lower risk of a composite MACE and all-cause mortality outcome

• 22% lower risk of acute kidney injury

Authors' comment

"These insights advocate for the integration of tirzepatide into therapeutic strategies for managing type 2 diabetes and highlight its potential to enhance current clinical practice."

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