The SUPPRESS-EARLY trial presented its 2-year results at the American Diabetes Association annual meeting, comparing the early initiation of tirzepatide with intensive conventional therapy for type 2 diabetes. Stefano Del Prato, a physician and investigator from the University of Pisa in Italy, reported on the findings.

"What happened is that in the tirzepatide-treated arm, 85% of the population at the end of the second year was on the maximum dose of tirzepatide 15 mg," Del Prato said. "And then the remaining 15 with the different doses." Regarding the comparison group, he stated, "Interestingly, in the population that had been treated with the intensive conventional approach, 85% of them ended up to have, on top of metformin, a GLP-1 receptor agonist, mainly represented by subcutaneous semaglutide [Ozempic, Wegovy], 60+%, another 15% on oral semaglutide [Rybelsus], and the remaining on dulaglutide [Trulicity]."

Del Prato described the glycemic outcomes: "Because the population that had been recruited in the study started off with a baseline A1C of 7.8% and it went down to 6.3% in the conventionally intensive treatment, which is not bad at all, on average is below the target of 6.5%." He continued, "However, when we look at the effect of tirzepatide, the final level of A1C at the end of the second year was 5.6%, which is on average below the upper limit of the normal range for A1C, 5.7%." This difference meant "around three times more people achieving an A1C of 5.7%, in the range of around 65%, as compared to 28% with people on a conventional optimized treatment."

Addressing other metabolic markers, Del Prato said, "This seems to be at least of interest and it's possibly changing the trajectory of the disease for glycemic control, as I mentioned, but also in terms of the body weight and waist circumference because both body weight and waist circumference went much lower with tirzepatide compared to the conventional treatment." He added, "Tirzepatide also was associated with an improvement in the lipid profile, in particular with the LDL, triglycerides, and the triglyceride concentration and non-HDL cholesterol, and also with a statistically significantly lower systolic blood pressure with a numerical reduction in the diastolic blood pressure."

Del Prato explained the trial design regarding medication load. "So tirzepatide was just metformin and tirzepatide," he said. "In the control group, there was already 10% of people who were receiving two drugs on top of the metformin." He concluded, "So another potential result of the trial is that it's possible to achieve and maintain better glycemic or better metabolic control over the time without really needing to increase the number of medications in order to achieve that goal." Del Prato noted that confirmation is pending: "Of course, we need to wait for the 4 years just to confirm that this is indeed the case, but the initial result seems to point along that line."