Lilly’s tirzepatide shows superiority over Novo’s semaglutide in type 2 diabetes trial

Eli Lilly’s investigational treatment tirzepatide beat Novo Nordisk’s semaglutide in a head-to-head trial in type 2 diabetes across a number of measures, the company announced.

The 40-week SURPASS-2 trial compared the efficacy and safety of three doses of tirzepatide – 5mg, 10mg and 15mg – to injectable semaglutide 1mg in adults with type 2 diabetes that were inadequately controlled with daily metformin alone.

Tirzepatide demonstrated superiority compared to semaglutide in all doses tested, with the highest dose – 15mg – reducing A1C by 2.46% and body weight by 13.1%.

The lowest dose of tirzepatide – 5mg – also reduced A1C by 2.09% and body weight by 8.5% compared to semaglutide, which had reductions of 1.86% and 6.7% respectively.

In addition, 51% of participants receiving tirzepatide 15mg achieved an A1C of less than 5.7% (the level seen in people without diabetes) compared to 20% for those taking semaglutide.

"Nearly nine in ten people with type 2 diabetes in the US are overweight or have obesity, and we are committed to providing solutions that not only lead to meaningful A1C reductions but also significant weight loss to help meet their needs," said Mike Mason, president, Lilly Diabetes.

"These striking head-to-head results surpassed our expectations, supporting our belief in the value of all three doses of tirzepatide as potential new treatment options for people living with type 2 diabetes,” he aded.

Tirzepatide is Lilly’s investigational once-weekly dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist.

Injectable semaglutide – also marketed under the brand name Ozempic by Novo – is a once-weekly GLP-1 agonist approved as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes.

Also within Novo’s roster is an oral formulation of semaglutide – marketed under the Rybelsus brand name – that is authorised for the treatment of type 2 diabetes.

Although it is difficult to draw cross-trial comparisons, Novo recently published results from a large-scale trial evaluating a higher dose of injectable semaglutide in adults who were obese or overweight.

This study enrolled a total of 1,964 adults with a body mass index (BMI) of 30 or higher, who were randomised to receive a once-weekly injection of semaglutide 2.4mg or placebo, plus lifestyle intervention.

Patients who were treated with semaglutide had an average reduction in body weight from baseline of 14.9%, compared to 2.4% for those receiving placebo.

More participants in the semaglutide-treated group also achieved a weight reduction of 5% or more – 86.4% for semaglutide and 31.5% for placebo.

Novo has already filed once-weekly semaglutide for weight management with both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA).