Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide

BACKGROUND: ) and body weight in the SURPASS phase 3 clinical trial program. OBJECTIVE: To compare efficacy and safety of escalation of dulaglutide dose versus switching to tirzepatide in inadequately controlled type 2 diabetes. DESIGN: Multicenter, randomized, open-label, phase 4 trial (SURPASS-SWITCH [A Phase 4, Randomized, Open-Label, Active-Controlled Study to Investigate the Efficacy and Safety of Switching from Weekly Dulaglutide to Weekly Tirzepatide in Adults with Type 2 Diabetes], ClinicalTrials.gov: NCT05564039). SETTING: 38 sites across 5 countries. PARTICIPANTS: or greater, receiving a stable dose of dulaglutide (0.75 or 1.5 mg) for at least 6 months and 0 to 3 oral antihyperglycemic medications for at least 3 months. INTERVENTION: Escalation of dulaglutide to 4.5 mg or maximum tolerated dose (MTD) or switching to tirzepatide. MEASUREMENTS: at week 40. The key secondary end point was change from baseline in weight at week 40. RESULTS: < 0.001]). Serious adverse events were reported by 10 (7.2%) tirzepatide and 10 (7.0%) dulaglutide participants. The most common treatment-emergent adverse events were nausea and diarrhea. LIMITATION: Open-label design. CONCLUSION: reduction and weight loss compared with escalating treatment with dulaglutide. PRIMARY FUNDING SOURCE: Eli Lilly and Company.