At present, nearly 1 billion people worldwide suffer from obesity, and about two-thirds of them also suffer from pre diabetes. The lifetime risk of this group of people suffering from diabetes is up to 70%. Improving health is the primary goal of obesity treatment. Drugs that directly target obesity and abnormal blood sugar can prevent diabetes from developing into type 2 diabetes in the early stage, and restore blood sugar to normal level, thus improving health benefits to a greater extent.

Tirzepatide, a glucose dependent insulin stimulating polypeptide and glucagon like peptide-1 (GIP/GLP-1) receptor dual agonist, has been approved in the United States and China for the treatment of type 2 diabetes, obesity and overweight patients. The SURMUNT-1 trial is a study exploring the effects of tiltrotide on obese individuals. Early data showed that in the first 72 weeks (the main phase of the trial), obese patients treated with tiltrotide 15 mg experienced an average weight loss of over 20% and a 0.51% reduction in glycated hemoglobin (HbA1C) levels.

Recently, the analysis of the results of the SURBOUNT-1 trial in the past four years was published in NEJM. The results showed that among obese patients with pre diabetes, compared with placebo treatment, the average weight of patients receiving telpoleptide treatment decreased by 20%, and the weight loss lasted for nearly four years, and the risk of progression to type 2 diabetes was significantly reduced by about 90%.

The paper points out that the advantage of this trial lies in its duration of up to 3.7 years (193 weeks), which adds new evidence to the long-term safety and efficacy of tilpotide.

SURMUNT-1 is an international multicenter, double-blind, randomized, placebo-controlled Phase 3 study conducted from December 2019 to July 2024. The published analysis results included 1032 obese patients with pre diabetes at the research baseline. Obesity was defined as: body mass index (BMI) ≥ 30 kg/m2 or BMI ≥ 27 kg/m2 and at least one obesity related complication. When they joined the study, their average age was 48.2 years, with 63.9% being female, an average weight of 107.3 kg, an average BMI of 38.8 kg/m2, and 37.2% of patients having a BMI ≥ 40 kg/m2.

These patients were randomly assigned in a 1:1:1:1 ratio to receive once a week treatment with tilboptide (5 mg, 10 mg, 15 mg) or subcutaneous placebo injection, for a total of 176 weeks (approximately 3.4 years), followed by a 17 week discontinuation period (a total of 193 weeks). All groups of patients received lifestyle interventions, including regular consultations with nutritionists or healthcare professionals on lifestyle (with a focus on balanced diet and reducing daily intake by 500 kcal), as well as at least 150 minutes of physical exercise per week.