Tirzepatide bests placebo, other glucose-lowering drugs at keeping lipid levels, waistline in check

Treatment with tirzepatide is associated with better lipid profile and waist circumference outcomes compared with placebo and other glucose-lowering drugs, according to a study.

For the study, researchers conducted a systematic review and meta-analysis to examine the effect of tirzepatide on certain risk factors for cardiovascular diseases in patients with type 2 diabetes (T2D). Multiple online databases were searched for relevant studies.

A total of seven randomized controlled trials with a minimum duration of 12 weeks and that compared tirzepatide with placebo or other antidiabetic medications met the eligibility criteria. Mean differences in lipid profile and waist circumference from baseline were estimated using the random-effects model. Meanwhile, the risk of bias and evidence quality were evaluated using the Cochrane risk-of-bias tool and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system, respectively.

The meta-analysis included eight articles from the seven trials, with a total sample of 7,151 participants. Pooled data showed that all three eligible maintenance doses of tirzepatide (5, 10, and 15 mg once a week) were all associated with greater improvements from baseline in total cholesterol (TC; p<0.05), high-density lipoprotein cholesterol (HDL-C; p<0.05), very low-density lipoprotein cholesterol (VLDL-C; p<0.01), triglyceride (TG; p<0.01), and waist circumference (p<0.01) compared with control agents including placebo, semaglutide, dulaglutide, and degludec.

However, while the quality of evidence for VLDL-C and TGs by GRADE was high or moderate, the quality of evidence for TC, HDL-C, and WC was low or moderate. Only the 5-mg once-weekly tirzepatide dosing (p<0.05) was able to induce significant improvements in LDL-C before sensitivity analysis. The quality of evidence was moderate.