Vnitr Lek 2025, 71(1):51-57 | DOI: 10.36290/vnl.2025.009

Tirzepatide - a promising medication for cardiovascular protection and treatment of Type 2 diabetes and obesity

Pavlína Pi»hová
Geriatrická interní klinika 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha

Tirzepatide is a dual GLP-1/GIP receptor agonist. It is very promising substance in treatment of Type 2 diabetes mellitus, obesity treatment, improvement of metabolic profile and cardiovascular protectivity. This article summarizes mechanisms of effect and results of finished clinical trials.

Keywords: tirzepatide, dual GLP-1/GIP receptor agonist, obesity treatment, cardioprotectivity.

Accepted: February 6, 2025; Published: February 18, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Pi»hová P. Tirzepatide - a promising medication for cardiovascular protection and treatment of Type 2 diabetes and obesity. Vnitr Lek. 2025;71(1):51-57. doi: 10.36290/vnl.2025.009.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Wang L. Designing a dual GLP-1R/GIPR agonist from tirzepatide: comparing residues between tirzepatide, GLP-1, and GIP. Drug Des Devel Ther. 2022;16:1547-1559. Go to original source... Go to PubMed...
    2. De Block C, Bailey C, Wysham C, et al. Tirzepatide for the treatment of adults with type 2 diabetes: An endocrine perspective. Diabetes Obes Metab. 2023;25(1):3-17. Go to original source... Go to PubMed...
    3. Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology. 2007;132(6):2131-2157. Go to original source... Go to PubMed...
    4. Coskun T, Sloop KW, Loghin C, et al. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: from discovery to clinical proof of concept. Molec Metab. 2018;18:3-14. Go to original source... Go to PubMed...
    5. Willard FS, Douros JD, Gabe MB, et al. Tirzepatide is an imbalanced and biased dual GIP and GLP-1 receptor agonist. JCI Insight. 2020;5(17):e140532. Go to original source... Go to PubMed...
    6. Rosenstock J, Wysham C, Frías JP, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet. 2021 Jul 10;398(10295):143-155. doi: 10.1016/S0140-6736(21)01324-6. Go to original source... Go to PubMed...
    7. Frías JP, Davies MJ, Rosenstock J, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021 Aug 5;385(6):503-515. doi: 10.1056/NEJMoa2107519. Epub 2021 Jun 25. PMID: 34170647. Go to original source... Go to PubMed...
    8. Ludvik B, Giorgino F, Jódar E, et al. Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial. Lancet. 2021 Aug 14;398(10300):583-598. doi: 10.1016/S0140-6736(21)01443-4. Epub 2021 Aug 6. PMID: 34370970. Go to original source... Go to PubMed...
    9. Del Prato S, Kahn SE, Pavo I, et al; SURPASS-4 Investigators. Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. Lancet. 2021 Nov 13;398(10313):1811-1824. doi: 10.1016/S0140-6736(21)02188-7. Epub 2021 Oct 18. PMID: 34672967. Go to original source... Go to PubMed...
    10. Heerspink HJL, Sattar N, Pavo I, et al. Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: post-hoc analysis of an open-label, randomised, phase 3 trial. Lancet Diabetes Endocrinol. 2022 Nov;10(11):774-785. doi: 10.1016/S2213-8587(22)00243-1. Epub 2022 Sep 21. PMID: 36152639. Go to original source... Go to PubMed...
    11. Dahl D, Onishi Y, Norwood P, et al. Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes: The SURPASS-5 Randomized Clinical Trial. JAMA. 2022 Feb 8;327(6):534-545. doi: 10.1001/jama.2022.0078. PMID: 35133415; PMCID: PMC8826179. Go to original source... Go to PubMed...
    12. Rosenstock J, Frías JP, Rodbard HW, et al. Tirzepatide vs Insulin Lispro Added to Basal Insulin in Type 2 Diabetes: The SURPASS-6 Randomized Clinical Trial. JAMA. 2023;330(17):1631-1640. doi:10.1001/jama.2023.20294 Go to original source... Go to PubMed...
    13. Nicholls SJ, Bhatt DL, Buse JB, et al; SURPASS-CVOT investigators. Comparison of tirzepatide and dulaglutide on major adverse cardiovascular events in participants with type 2 diabetes and atherosclerotic cardiovascular disease: SURPASS-CVOT design and baseline characteristics. Am Heart J. 2024 Jan;267:1-11. doi: 10.1016/j.ahj.2023. 09. 007. Epub 2023 Sep 25. PMID: 37758044. Go to original source...
    14. Jastreboff AM, Aronne LJ, et al; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024. Go to original source... Go to PubMed...
    15. Jastreboff AM, le Roux CW, Stefanski A, et al; SURMOUNT-1 Investigators. Tirzepatide for Obesity Treatment and Diabetes Prevention. N Engl J Med. 2024 Nov 13. doi: 10.1056/NEJMoa2410819. Epub ahead of print. PMID: 39536238. Go to original source... Go to PubMed...
    16. Goff DC, Lloyd-Jones DM, D'Agostino RB, et al. Report on the assess ment of cardiovascular risk: full work group report supplement. 2013. http://jaccjacc.cardiosource.com/acc_documents/2013_FPR_S5_ Risk_Assesment.pdf
    17. Hankosky ER, Wang H, Neff LM, et al. Tirzepatide reduces the predicted risk of atherosclerotic cardiovascular disease and improves cardiometabolic risk factors in adults with obesity or overweight: SURMOUNT-1 post hoc analysis. Diabetes Obes Metab. 2024 Jan;26(1):319-328. doi: 10.1111/dom.15318. Epub 2023 Nov 6. PMID: 37932236. Go to original source... Go to PubMed...
    18. Garvey WT, Frias JP, Jastreboff AM, et al; SURMOUNT-2 investigators. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023 Aug 19;402(10402):613-626. doi: 10.1016/S0140-6736(23)01200-X. Epub 2023 Jun 26. PMID: 37385275. Go to original source... Go to PubMed...
    19. Wadden TA, Chao AM, Machineni S, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023 Nov;29(11):2909-2918. doi: 10.1038/s41591-023-02597-w. Epub 2023 Oct 15. Erratum in: Nat Med. 2024 Jun;30(6):1784. doi: 10.1038/s41591-024-02883-1. PMID: 37840095; PMCID: PMC10667099. Go to original source... Go to PubMed...
    20. Aronne LJ, Sattar N, Horn DB, et al; SURMOUNT-4 Investigators. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024 Jan 2;331(1):38-48. doi: 10.1001/jama.2023.24945. PMID: 38078870; PMCID: PMC10714284. Go to original source... Go to PubMed...
    21. Guo X, Lei M, Zhao J, et al. Tirzepatide ameliorates spatial learning and memory impairment through modulation of aberrant insulin resistance and inflammation response in diabetic rats. Front Pharmacol. 2023;14:1146960. https://doi.org/10.3389/fphar.2023.1146960. Go to original source... Go to PubMed...
    22. Malhotra A, Grunstein RR, Fietze I, et al; SURMOUNT-OSA Investigators. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med. 2024 Oct 3;391(13):1193-1205. doi: 10.1056/NEJMoa2404881. Epub 2024 Jun 21. Erratum in: N Engl J Med. 2024 Oct 17;391(15):1464. doi: 10.1056/NEJMx240005. PMID: 38912654; PMCID: PMC11598664. Go to original source... Go to PubMed...
    23. Quddos F, Hubshman Z, Tegge A, et al. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Sci Rep. 2023 Nov 28;13(1):20998. doi: 10.1038/s41598-023-48267-2. PMID: 38017205; PMCID: PMC1068450. Go to original source... Go to PubMed...
    24. Loomba R, Hartman ML, Lawitz EJ, et al; SYNERGY-NASH Investigators. Tirzepatide for Metabolic Dysfunction-Associated Steatohepatitis with Liver Fibrosis. N Engl J Med. 2024 Jul 25;391(4):299-310. doi: 10.1056/NEJMoa2401943. Epub 2024 Jun 8. PMID: 38856224. Go to original source... Go to PubMed...
    25. Standarts in Care of Diabetes: https://diabetesjournals.org/care/article/48/Supplement_1/S6/157564/Summary-of-Revisions-Standards-of-Care-in-Diabetes.
    26. 2020: Doporučený postup péče o diabetes mellitus 2. typu + příloha Algoritmus terapie. Avalilable from www.diab.cz/standardy.
    27. Standards of medical care in diabetes - 2022 abridged for primary care providers. Diabetes. 2022;40(1):10-38.
    28. Mounjaro 2,5 mg injekční roztok v předplněném peru. Mounjaro 5 mg injekční roztok v předplněném peru. Mounjaro 7,5 mg injekční roztok v předplněném peru. Mounjaro 10 mg injekční roztok v předplněném peru. Souhrn údajů o přípravků. Available from https://www.ema.europa.eu/cs/documents/product-information/mounjaro-epar-product-information_cs.pdf).

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.