Lilly’s tirzepatide Surpasses Novo’s Ozempic

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Is it time to crown a new diabetes champion? Lilly’s novel project tirzepatide, which has looked passable in the pivotal trials reported before today, might have finally landed the knockout blow against its big rival, Novo Nordisk’s Ozempic. The 1,900-patient pivotal Surpass-2 study found that all doses of tirzepatide tested were statistically significantly better than a 1mg dose of Ozempic in terms of HbA1c reduction and weight loss – without adding much, if anything, in terms of toxicity. GI tolerability had been a big worry with the Lilly project following other Surpass trial readouts. In Surpass-2, tirzepatide also impressed by reducing HbA1c levels to under 5.7% – essentially normal – in 46% of patients receiving the highest dose, versus just 19% of patients on Ozempic. Novo might argue that a 2mg dose of Ozempic, which it recently filed with the FDA for diabetes, could be a more relevant comparator, but a cross-trial comparison shows that on weight loss at least tirzepatide still has the edge. In obesity the Step 1 study reported 15kg weight loss with injectable semaglutide, Ozempic’s active ingredient, but that was with a higher dose still, 2.4mg, and in patients who were heavier at baseline.

Tirzepatide vs Ozempic: head-to-head and cross-trial comparison data
  Tirzepatide 5mg Tirzepatide 10mg Tirzepatide 15mg Ozempic 1mg Ozempic 2mg*
A1c reduction (%) 2.01 2.24 2.30 1.86 2.10
% of pts achieving A1c <7% 82** 86 86 79 68
Weight loss (kg) 7.6 9.3 11.2 5.7 6.4
Nausea (%) 17 19 22 18 ~15
Diarrhoea (%) 13 16 14 12 Not given
Vomiting (%) 6 9 10 8 Not given
Discontinuations due to AEs (%) 5 8 8 4 ~5
All treatment-regimen estimands; *dose not included in Surpass-2, cross-trial comparison from Sustain-Forte study; **not statistically significantly superior vs Ozempic, all other efficacy results statistically significantly superior. Source: company releases.

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