It's Monday and time for us @GoggleDocs to #takeover the @cardiomet_CE account for the next few days.
It's time to revisit the recent #EASD2021 conference.
Highlights in what's new in
#T1D
#type2diabetes
#NAFLD
#CKD
#HeartFailure
Just to remind you guys
The @GoggleDocs are a bunch of 🇬🇧 docs/🤓 who are fascinated about the cardio-metabolic conditions we are increasingly managing.
Please check out our @YouTube channel
youtube.com/channel/UC8Tzu…
This accredited educational program is intended for healthcare providers only, and is supported by grants from AstraZeneca, Bayer, Chiesi, and NovoNordisk. Follow this thread for a link to credit. CE/#CME credit for #physicians, #nurses, #pharmacists in US, Canada, GB, EU.
Up first a bit of our own "Back to the Future"!
At the #EASD2021 conference we learned more about the exciting new Dual (GIP/GLP-1) increatin agonist #tirzepatide
After this we will briefly cover the latest data coming from @LillyPad incretin lab LY343943 aka "Triple G"
#tirzepatide an investigational molecule with impressive published phase 3 data
new at #EASD2021 3 x RCT
1⃣ SURPASS-3 MRI - Looking at Liver/abdominal fat etc...
2⃣SURPASS-3 CGM - looking at time in range
3⃣SURPASS - 5 - tirzepatide vs ins. glargine in High CV risk participants
For a reminder of this molecule and the benefits in terms of ⤵️ HbA1c and ⤵️weight even when compared with current 🥇 in class therapies like semaglutide 1mg check ou the following thread.
👇
A reminder of the SURPASS-3 trial
📍52w open-label phase 3 RCT
📍Insulin naive #type2diabetes
📍QW tirzepatide 5, 10 & 15mg vs insulin degludec
📍Tirzepatide compared to ins. degludec assoc with:
▶️HbA1c⤵️ 0.59-1.03%
▶️wt⤵️ 9.8-15.2 kg
full paper 👉tinyurl.com/SURPASS3
SURPASS-3 MRI trial (1/3)
📍sub-study of SURPASS-3 (n=296)
📍1ry objective - change liver fat change at 52w
📍2ry objective - volume abdominal visceral & sub-cut. abdominal fat volume, and change from baseline
SURPASS-3 MRI trial (2/3)
📍treatment with tirzepatide 5-15mg compared to ins. degludec assoc with:
🌟Liver fat content (LFC)⤵️ 18-28%
Both ⤵️ in either HbA1c or weight assoc with ⤵️
✅ Both the visceral & subcutaneous abdominal fat ⤵️ equally
✅ ALT⤵️ 4-22%
✅ AST⤵️ 10-19%
SURPASS-3 MRI trial (3/3)
📍tirzepatide (particularly 10-15mg doses) looks to be possible treatments for #NAFLD #NASH, as well as #type2diabetes
📍ongoing liver outcome RCT with liver biopsy
👉clinicaltrials.gov/ct2/show/NCT04…
SURPASS-3 CGM (1/2)
📍 another sub-study of SURPASS-3 (n=243)
📍Dexcom G6 CGM used
📍1ry outcome - Time within Tight Target range 3.9-7.8 mmol/mol (71-140 mg/dL) at 24 + 52w
📍% time within standard target range 3.9-10 mmol/mol (71-180 mg/dL) at 52w
Presented by @TBattelino
SURPASS - CGM (2/2)
tirzepatide treatment assoc with:
📍 Marked ⤴️ in Tight TIR compared to ins. degludec at 24w & 52w ✅
📍⤴️ standard TIR ✅
In addition to
⤵️ HbA1c
⤵️⤵️ wt
⤵️ time in hyperglycaemia range
⤵️ time in hypoglycaemia range
‼️Basically it does a fabulous job
SURPASS-4 (1/5)
⚠️One concerns 1 from SURPASS-2 was a small excess in mortality seen in the tirzepatide arm vs the semaglutide arm.
📍52w open-label RCT
📍high CV risk #type2diabetes
📍tirzepatide 5-15mg) vs insulin glargine
📍study pop
63 yr
♀️ 37%
👴🏻81.8%
Hx CV dis 86%
SURPASS-4 (2/5)
tirzepatide (5-15mg) vs insulin glargine assoc with ...
📍HbA1c ⤵️ 8.8-12.5 mmol/mol
📍wt ⤵️ 9.0-13.5 kg
📍66% on 15mg dose >10% wt loss❗️
📍37% on 15mg dose >15% wt loss ‼️
SURPASS-4 (3/5)
Tirzepatide treatment assoc with...
⤵️ Systolic BP
⤵️Diastolic BP
⤴️ HDL
⤵️ TG
⤵️ Tot Cholesterol
⤴️ Heart rate
⤴️ Hypoglycaemia (particularly if on sulfonylureas ‼️)
SURPASS-4 (4/5)
Tolerability & safety of tirzpatide
📍Similar GI side-effects to GLP-1ra (i.e.🤢🤮💩)
📍Numerically fewer 4-point MACE events particularly after 52w 👍
SURPASS-4 (5/5)
📍🏆 standard ⤵️ HbA1c & ⤵️ weight
📍No new safety signal
📍Improvements in traditional CV risk factors
📍Numerically fewer 4-point MACE events
👏👏👏
📍 SURPASS-CVOT powered to formally CV safety/benefit 👇
clinicaltrials.gov/ct2/show/NCT04……
"Triple G" (1/4)
"Triple G" (2/4)
With tirzepatide we can see the benefits of dual over single incretin agonists.
So what about triple agonists (GIP/GLP-1/Glucagon)⁉️
Let us introduce you to @LillyPad latest exciting molecule
📍LY3437943 aka "Triple G"
"Triple G" (3/4)
📍🐭 study
✅ "Triple G" beats tirzepatide‼️ (well at least in 🐁)
⤵️ wt
⤴️ insulin secretion
⤴️ insulin sensitivity
⤵️ Liver fat content
👏👏👏
"Triple G" (4/4)
📍data from the 1st in human phase 1 study (n=47)
⚠️healthy human subjects
▶️ 6 day half-life. Making it ideal for QW dosing✅
▶️ GI side-effects "similar" to other incretins✅
▶️⤵️ wt & appetite✅
▶️⤴️ heart rate⚠️
‼️keep your 👀 on "Triple G"‼️
Keep checking the @cardiomet_CE account for more from #EASD2021
The @GoggleDocs never stop and it won't be long before we are posting away as part of our #TAKEOVER of this account.
Next up will be away from drugs to food...
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