6/29/23, 11:57 PM SURPASS-4 (post-hoc analysis) Pathway Feedback Search Clinical Topics Home Studies SURPASS 4 (post-hoc analysis) SURPASS 4 (post-hoc analysis) Disease Diabetes mellitus type 2 Trial question Is tirzepatide superior to insulin glargine in patients with T2DM with regard to renal outcomes? Study design Multi-center Open label RCT Population 1995 patients Inclusion criteria: adults with inadequately controlled T2DM on oral diabetes medication and high cardiovascular risk Key exclusion criteria: T1DM mellitus, chronic or acute pancreatitis, acute or chronic hepatitis, diabetic retinopathy requiring urgent treatment, heart attack or stroke in the past 2 months Interventions N=995 tirzepatide (once-weekly subcutaneous injection at a dose of 5 mg, 10 mg, or 15 mg) N=1000 insulin glargine (once-daily subcutaneous injection titrated to 100 U/mL) Primary outcome Estimated glomerular filtration decline 3.6 mL/min/1.73m 3.6 2.7 mL/min/1.73m 1.8 mL/min/1.73m 1.4 0.9 mL/min/1.73m https://web.pathway.md/studies/recoQgT4uDNUJH5wO 1/2 6/29/23, 11:57 PM SURPASS-4 (post-hoc analysis) Pathway Significant decrease 0.0 mL/min/1.73m Tirzepatide Insulin glargine Significant decrease in estimated glomerular filtration decline (1.4 mL/min/1.73 m vs. 3.6 mL/min/1.73 m ; AD -2.2 mL/min/1.73 m , 95% CI -1.6 to -2.8) Secondary outcomes Significant increase in urine albumin-creatinine ratio reduction (6.8% vs. -36.9%; AD 31.9%, 95% CI 25.7 to 37.7) Conclusion In adults with inadequately controlled T2DM on oral diabetes medication and high cardiovascular risk, tirzepatide was superior to insulin glargine with respect to estimated glomerular filtration decline. Reference Hiddo J L Heerspink, Naveed Sattar, Imre Pavo 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 Sep 21;S2213-8587(22)00243-1. Open reference URL https://web.pathway.md/studies/recoQgT4uDNUJH5wO 2/2