Tirzepatide versus insulin glargine as second-line or third-line therapy in type 2 diabetes in the Asia-Pacific region: the SURPASS-AP-Combo trial.

Gao L, Lee BW, Chawla M, Kim J, Huo L, Du L, Huang Y, Ji L

Nature medicine25 May 2023Cited by 80 (Europe PMC)

PMID37231074DOI10.1038/s41591-023-02344-1PepBankPUB-37231074

Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study13

13 results from studies that gave the peptide. 13 results from people.

01HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes uncontrolled on metformin, tirzepatide 15 mg was non-inferior and superior to insulin glargine in lowering HbA1c at week 40.
In plain wordsIn adults with type 2 diabetes, tirzepatide 15 mg lowered HbA1c more than insulin glargine after 40 weeks.
Peptide
Tirzepatide
Outcome
DecreaseHbA1c change from baseline at week 40 (15 mg)
Study
n = 459
Comparator
Insulin glargine
Analysis
Primary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
15 mg once weekly · 40 weeksAs given in this study (human).
Measurements
HbA1c change
−2.49%
tirzepatide 15 mg
HbA1c change
−0.95%
insulin glargine
Source sentences
Summary
All doses of tirzepatide were non-inferior and superior to insulin glargine for least squares mean (s.e.) reduction in HbA1c from baseline to week 40: tirzepatide 5 mg, 10 mg and 15 mg, -2.24% (0.07), -2.44% (0.07) and -2.49% (0.07), respectively, and insulin glargine, -0.95% (0.07), with a treatmen…
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107403
02HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes uncontrolled on metformin, tirzepatide 10 mg was non-inferior and superior to insulin glargine in lowering HbA1c at week 40.
In plain wordsIn adults with type 2 diabetes, tirzepatide 10 mg lowered HbA1c more than insulin glargine after 40 weeks.
Peptide
Tirzepatide
Outcome
DecreaseHbA1c change from baseline at week 40 (10 mg)
Study
n = 458
Comparator
Insulin glargine
Analysis
Primary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
10 mg once weekly · 40 weeksAs given in this study (human).
Measurements
HbA1c change
−2.44%
tirzepatide 10 mg
HbA1c change
−0.95%
insulin glargine
Source sentences
Summary
All doses of tirzepatide were non-inferior and superior to insulin glargine for least squares mean (s.e.) reduction in HbA1c from baseline to week 40: tirzepatide 5 mg, 10 mg and 15 mg, -2.24% (0.07), -2.44% (0.07) and -2.49% (0.07), respectively, and insulin glargine, -0.95% (0.07), with a treatmen…
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107402
03HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes uncontrolled on metformin, tirzepatide 5 mg was non-inferior and superior to insulin glargine in lowering HbA1c at week 40.
In plain wordsIn adults with type 2 diabetes, tirzepatide 5 mg lowered HbA1c more than insulin glargine after 40 weeks.
Peptide
Tirzepatide
Outcome
DecreaseHbA1c change from baseline at week 40 (5 mg)
Study
n = 460
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
5 mg once weekly · 40 weeksAs given in this study (human).
Measurements
HbA1c change
−2.24%
tirzepatide 5 mg
HbA1c change
−0.95%
insulin glargine
Source sentences
Summary
All doses of tirzepatide were non-inferior and superior to insulin glargine for least squares mean (s.e.) reduction in HbA1c from baseline to week 40: tirzepatide 5 mg, 10 mg and 15 mg, -2.24% (0.07), -2.44% (0.07) and -2.49% (0.07), respectively, and insulin glargine, -0.95% (0.07), with a treatmen…
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107401
04HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes, more patients reached HbA1c below 7.0% at week 40 with tirzepatide 5 mg than with insulin glargine.
In plain wordsIn adults with type 2 diabetes, more people reached HbA1c below 7.0% on tirzepatide 5 mg than on insulin glargine.
Peptide
Tirzepatide
Outcome
IncreaseHbA1c below 7.0% at week 40 (5 mg)
Study
n = 460
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
5 mg once weekly · 40 weeksAs given in this study (human).
Measurements
Patients with HbA1c <7.0%
75.4%
tirzepatide 5 mg
Patients with HbA1c <7.0%
23.7%
insulin glargine
Source sentences
Summary
Proportions of patients achieving HbA1c < 7.0% at week 40 were greater in tirzepatide 5-mg (75.4%), 10-mg (86.0%) and 15-mg (84.4%) groups compared to insulin glargine (23.7%) (all P < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107404
05HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes, tirzepatide 5 mg gave a superior body weight reduction at week 40 versus insulin glargine, which led to weight gain.
In plain wordsIn adults with type 2 diabetes, tirzepatide 5 mg reduced weight while insulin glargine led to weight gain.
Peptide
Tirzepatide
Outcome
DecreaseBody weight change at week 40 (5 mg)
Study
n = 460
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Body weight · Metabolic and weight
Studied dose
5 mg once weekly · 40 weeksAs given in this study (human).
Measurements
Body weight change
−5 kg
tirzepatide 5 mg
Body weight change
−6.5%
tirzepatide 5 mg
Body weight change
1.5 kg
insulin glargine
Source sentences
Summary
All tirzepatide doses led to superior body weight reduction at week 40: tirzepatide 5 mg, 10 mg and 15 mg, -5.0 kg (-6.5%), -7.0 kg (-9.3%) and -7.2 kg (-9.4%), respectively, compared to insulin glargine, 1.5 kg (+2.1%) (all P < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107407
06HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes, more patients reached HbA1c below 7.0% at week 40 with tirzepatide 15 mg than with insulin glargine.
In plain wordsIn adults with type 2 diabetes, more people reached HbA1c below 7.0% on tirzepatide 15 mg than on insulin glargine.
Peptide
Tirzepatide
Outcome
IncreaseHbA1c below 7.0% at week 40 (15 mg)
Study
n = 459
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
15 mg once weekly · 40 weeksAs given in this study (human).
Measurements
Patients with HbA1c <7.0%
84.4%
tirzepatide 15 mg
Patients with HbA1c <7.0%
23.7%
insulin glargine
Source sentences
Summary
Proportions of patients achieving HbA1c < 7.0% at week 40 were greater in tirzepatide 5-mg (75.4%), 10-mg (86.0%) and 15-mg (84.4%) groups compared to insulin glargine (23.7%) (all P < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107406
07HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes, tirzepatide 15 mg gave a superior body weight reduction at week 40 versus insulin glargine, which led to weight gain.
In plain wordsIn adults with type 2 diabetes, tirzepatide 15 mg reduced weight while insulin glargine led to weight gain.
Peptide
Tirzepatide
Outcome
DecreaseBody weight change at week 40 (15 mg)
Study
n = 459
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Body weight · Metabolic and weight
Studied dose
15 mg once weekly · 40 weeksAs given in this study (human).
Measurements
Body weight change
−7.2 kg
tirzepatide 15 mg
Body weight change
−9.4%
tirzepatide 15 mg
Body weight change
1.5 kg
insulin glargine
Source sentences
Summary
All tirzepatide doses led to superior body weight reduction at week 40: tirzepatide 5 mg, 10 mg and 15 mg, -5.0 kg (-6.5%), -7.0 kg (-9.3%) and -7.2 kg (-9.4%), respectively, compared to insulin glargine, 1.5 kg (+2.1%) (all P < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107409
08HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes, more patients reached HbA1c below 7.0% at week 40 with tirzepatide 10 mg than with insulin glargine.
In plain wordsIn adults with type 2 diabetes, more people reached HbA1c below 7.0% on tirzepatide 10 mg than on insulin glargine.
Peptide
Tirzepatide
Outcome
IncreaseHbA1c below 7.0% at week 40 (10 mg)
Study
n = 458
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
10 mg once weekly · 40 weeksAs given in this study (human).
Measurements
Patients with HbA1c <7.0%
86%
tirzepatide 10 mg
Patients with HbA1c <7.0%
23.7%
insulin glargine
Source sentences
Summary
Proportions of patients achieving HbA1c < 7.0% at week 40 were greater in tirzepatide 5-mg (75.4%), 10-mg (86.0%) and 15-mg (84.4%) groups compared to insulin glargine (23.7%) (all P < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107405
09HumanRandomized controlled trialEfficacy outcome
In insulin-naive adults with type 2 diabetes, tirzepatide 10 mg gave a superior body weight reduction at week 40 versus insulin glargine, which led to weight gain.
In plain wordsIn adults with type 2 diabetes, tirzepatide 10 mg reduced weight while insulin glargine led to weight gain.
Peptide
Tirzepatide
Outcome
DecreaseBody weight change at week 40 (10 mg)
Study
n = 458
Comparator
Insulin glargine
Analysis
Secondary
Outcome group
Body weight · Metabolic and weight
Studied dose
10 mg once weekly · 40 weeksAs given in this study (human).
Measurements
Body weight change
−7 kg
tirzepatide 10 mg
Body weight change
−9.3%
tirzepatide 10 mg
Body weight change
1.5 kg
insulin glargine
Source sentences
Summary
All tirzepatide doses led to superior body weight reduction at week 40: tirzepatide 5 mg, 10 mg and 15 mg, -5.0 kg (-6.5%), -7.0 kg (-9.3%) and -7.2 kg (-9.4%), respectively, compared to insulin glargine, 1.5 kg (+2.1%) (all P < 0.001).
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107408
10HumanRandomized controlled trialSafety outcome
In insulin-naive adults with type 2 diabetes, no severe hypoglycemia was reported.
In plain wordsIn adults with type 2 diabetes, no severe low blood sugar was reported in the trial.
Peptide
Tirzepatide
Outcome
No significant changeSevere hypoglycemia
Study
n = 917
Outcome group
Adverse events · Metabolic and weight
Studied dose
5, 10 or 15 mg once weekly · 40 weeksAs given in this study (human).
Source sentences
Summary
No severe hypoglycemia was reported.
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107413
11HumanRandomized controlled trialSafety outcome
In insulin-naive adults with type 2 diabetes, decreased appetite was among the most common adverse events with tirzepatide and was mild to moderate.
In plain wordsIn adults with type 2 diabetes, reduced appetite was one of the most common side effects of tirzepatide, mild to moderate.
Peptide
Tirzepatide
Outcome
Direction not reportedDecreased appetite
Study
n = 687
Outcome group
Adverse events · Whole body
Studied dose
5, 10 or 15 mg once weekly · 40 weeksAs given in this study (human).
Source sentences
Summary
The most common adverse events with tirzepatide were mild to moderate decreased appetite, diarrhea and nausea.
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107410
12HumanRandomized controlled trialSafety outcome
In insulin-naive adults with type 2 diabetes, diarrhea was among the most common adverse events with tirzepatide and was mild to moderate.
In plain wordsIn adults with type 2 diabetes, diarrhea was one of the most common side effects of tirzepatide, mild to moderate.
Peptide
Tirzepatide
Outcome
Direction not reportedDiarrhea
Study
n = 687
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
5, 10 or 15 mg once weekly · 40 weeksAs given in this study (human).
Source sentences
Summary
The most common adverse events with tirzepatide were mild to moderate decreased appetite, diarrhea and nausea.
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107411
13HumanRandomized controlled trialSafety outcome
In insulin-naive adults with type 2 diabetes, nausea was among the most common adverse events with tirzepatide and was mild to moderate.
In plain wordsIn adults with type 2 diabetes, nausea was one of the most common side effects of tirzepatide, mild to moderate.
Peptide
Tirzepatide
Outcome
Direction not reportedNausea
Study
n = 687
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
5, 10 or 15 mg once weekly · 40 weeksAs given in this study (human).
Source sentences
Summary
The most common adverse events with tirzepatide were mild to moderate decreased appetite, diarrhea and nausea.
1 context sentence(design, population, supporting numbers)
Summary · context
In this phase 3, randomized, open-label trial, insulin-naive adults (≥18 years of age) with type 2 diabetes (T2D) uncontrolled on metformin (with or without a sulphonylurea) were randomized 1:1:1:1 to weekly tirzepatide 5 mg, 10 mg or 15 mg or daily insulin glargine at 66 hospitals in China, South K…
Report a problemFND-3723107412

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT04093752

A Study of Tirzepatide (LY3298176) in Participants With Type 2 Diabetes on Metformin With or Without Sulfonylurea (SURPASS-AP-Combo)

Eli Lilly and Companyn = 9179 Dec 2019 to 24 Nov 2021

Type 2 Diabetes

Trial page ClinicalTrials.govUpdated 6 Jan 2023

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
12 Oct 2026, 12:58 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

Publication types

MeSH terms

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