In the SURPASS-1 study, tirzepatide 5 mg, 10 mg and 15 mg were associated with mean HbA1c reductions of 1.87%, 1.89% and 2.07%, respectively, over 40 weeks. In the SURPASS-4 study among patients with type 2 diabetes using any combination of metformin, sulfonylureas, or SGLT-2 inhibitors, tirzepatide was associated with up to 2.58% mean HbA1c reduction.

In the SURMOUNT-1 study, participants experienced mean weight loss of 15%, 19.5% and 20.9% over 72 weeks with tirzepatide 5 mg, 10 mg and 15 mg, respectively. in SURMOUNT-5 study, nearly 1 in 5 patients treated with tirzepatide, experienced at least 30% weight loss.

In clinical studies, participants treated with tirzepatide experienced a percent reduction in fat mass approximately three times greater than the reduction in lean mass which resulted in an overall improvement in body composition.

In the SURMOUNT-1 study, weight loss with tirzepatide was accompanied by improvements in all measured cardiometabolic risk factors, including waist circumference, systolic and diastolic blood pressure (with reduction of 7.2 mm Hg and 4.8 mmHg, respectively), fasting insulin, and lipid profile (including a 24.8 mg/dl reduction in triglyceride and an 8 mg increase in HDL cholesterol, along with reductions in total and LDL cholesterol).

Spartina^® can be administered at any time of the day with or without food. It is recommended to administer Spartina^® on the same day each week.

For patients on the 2.5 mg/week dose, reinitiate at 2.5 mg once weekly. For patients on doses ≥5 mg/week:

• If 2 or fewer doses missed: Reinitiate at the same dose if previously tolerated.
• If 3 or more doses missed: Reinitiate at 5 mg once weekly.

No, Spartina^® is contraindicated only in individuals with a personal or family history of medullary thyroid carcinoma (MTC), or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Prior to initiating therapy, postsurgical fluid requirements and volume status should be evaluated, corrected and maintained and the patient should be closely monitored for the duration of therapy to prevent dehydration.

After gastric bypass or sleeve gastrectomy (but not gastric band), when initiating GLP-1 receptor agonists, efficacy and signs of pancreatitis should be monitored, as these surgeries increase endogenous GLP-1, potentially making additional GLP-1 exposure redundant.

The most common adverse reactions reported in patients treated with tirzepatide are nausea, diarrhea, constipation, vomiting and decreased appetite. Gastrointestinal adverse reactions may occur after the initiation of tirzepatide and during dose escalation, although they are usually transient and improve over time.

The following tips will help reduce gastrointestinal adverse reaction:

• Ensuring adequate hydration
• Eating smaller meal (e.g., splitting 3 daily meals into 4 or more smaller ones)
• Choosing easily digestible foods, and avoiding gastric irritants (such as spices and alcohol)
• Avoidance of eating when feeling full
• Slow dose escalation
• Consideration of the temporary use of symptom-relief medications during dose escalation

Spartina^® may increase adverse/toxic effects of GLP-1 agonists (e.g., liraglutide and semaglutide); concomitant use of these medicines should be avoided.

Spartina^® may enhance the hypoglycemic effect of insulin and sulfonylureas; dose reductions of these agents should be considered.

Concomitant use with dipeptidyl peptidase-4 (DPP-4) inhibitors (e.g., sitagliptin and linagliptin) should be avoided due to the lack of additive glycemic benefit.