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  1. Medical Information Right
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  4. How do you switch patients from a glucagon-like peptide-1 receptor agonist (GLP-1 RA) to Mounjaro® (tirzepatide)?
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Mounjaro ® (tirzepatide) injection

2.5 mg/5 mg/7.5 mg/10 mg/12.5 mg/15 mg

Full Prescribing Information

This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.

How do you switch patients from a glucagon-like peptide-1 receptor agonist (GLP-1 RA) to Mounjaro® (tirzepatide)?

Lilly cannot recommend how to switch from a GLP-1 RA to tirzepatide. Data from SURPASS-SWITCH and SURPASS-SWITCH-2 are described in this response. Healthcare providers should determine the best course for each patient when considering medication changes.

US_cFAQ_TZP013_SWITCHING_FROM_GLP-1RA_T2D_CWM
US_cFAQ_TZP013_SWITCHING_FROM_GLP-1RA_T2D_CWMen-US

See important safety information, including boxed warning, in the attached prescribing information.

Content Overview

General Considerations Before Switching Patients to Tirzepatide From Other GLP1-RAs

Switching From a GLP-1 RA to Tirzepatide for Weight Management

Switching From a GLP-1 RA to Tirzepatide for Type 2 Diabetes

Switching From Dulaglutide to Tirzepatide in SURPASS-SWITCH

Switching From a GLP-1 RA to Tirzepatide in SURPASS-SWITCH-2

General Considerations Before Switching Patients to Tirzepatide From Other GLP1-RAs

Eli Lilly and Company cannot provide information on

  • how to switch a patient from a glucagon-like peptide-1 receptor agonist (GLP-1 RA) to tirzepatide, or 
  • dose equivalence between GLP1-RAs and tirzepatide.

In formulating an assessment and approach, the healthcare practitioner may consider

  • the information provided
  • the patient’s prior medical history and concomitant medications, and
  • other individual factors.

The healthcare practitioner should consider the potential risks and benefits of treatment options and monitor them appropriately.

The recommended starting dose of tirzepatide is 2.5 mg injected subcutaneously once weekly. Follow the dosage escalation below to reduce the risk of gastrointestinal adverse reactions.​ The 2.5 mg dosage is for treatment initiation and is not intended for glycemic control.1

After 4 weeks, increase the dose to 5 mg once weekly. If additional glycemic control is needed, increase the dosage in 2.5 mg increments after at least 4 weeks on the current dose. The maximum dosage of tirzepatide is 15 mg once weekly.1

The SURPASS-SWITCH and SURPASS-SWITCH-2 studies provided examples of transitions from a stable dose of a GLP-1 RA to tirzepatide in adults with type 2 diabetes (T2D).2,3 These studies evaluated specific switching scenarios and clinical situations that may not represent clinical practice scenarios.

SURPASS-SWITCH compared dose escalation of dulaglutide versus switching to tirzepatide in people with T2D inadequately controlled on submaximal doses of dulaglutide.2 This study does not allow general conclusions on how to switch from GLP-1 RAs to tirzepatide.

SURPASS-SWITCH-2 was a 12-week, open-label, single-arm study that evaluated switching from a stable GLP-1 RA to tirzepatide 5 mg, omitting the 2.5 mg initiation dose. This study was not designed to inform longer-term outcomes, comparative efficacy, or define the optimal transition strategy, as that depends on many individual characteristics.4

Switching From a GLP-1 RA to Tirzepatide for Weight Management

Lilly has not sponsored a clinical study to evaluate switching from a GLP-1 RA to tirzepatide for weight management.

Switching From a GLP-1 RA to Tirzepatide for Type 2 Diabetes

In adults with T2D, switching from a GLP-1 RA to tirzepatide was evaluated in 2 phase 4 studies,

  • Switching From Dulaglutide to Tirzepatide in SURPASS-SWITCH, and
  • Switching From a GLP-1 RA to Tirzepatide in SURPASS-SWITCH-2.2,3

In both studies, participants switched from a stable dose of GLP-1RA to tirzepatide without a wash-out period. For more details, please refer to

  • How Participants Escalated Dulaglutide or Switched to Tirzepatide in SURPASS-SWITCH, and 
  • How Participants Switched From Semaglutide, Dulaglutide, or Liraglutide to Tirzepatide in SURPASS-SWITCH -2.

Switching From Dulaglutide to Tirzepatide in SURPASS-SWITCH

SURPASS-SWITCH was a phase 4, randomized, open-label, active-controlled, parallel group, multi-national trial that assessed the efficacy and safety of escalating dulaglutide dosage versus switching to tirzepatide in adult participants with inadequately controlled T2D over 40 weeks.2

Eligible participants had T2D inadequately controlled on stable doses of dulaglutide 0.75 mg or 1.5 mg. In SURPASS-SWITCH, participants were randomly assigned in a 1:1 ratio to

  • escalate dulaglutide to 4.5 mg or maximum tolerated dose (MTD), or
  • switch to tirzepatide 15 mg or MTD.2

Key Inclusion and Exclusion Criteria in the SURPASS-SWITCH Study 

Key inclusion and exclusion criteria for the SURPASS-SWITCH study are presented in Key Inclusion and Exclusion Criteria in the SURPASS-SWITCH Study.

Key Inclusion and Exclusion Criteria in the SURPASS-SWITCH Study2

Key Inclusion Criteria

Key Exclusion Criteria 

  • Adults ≥18 years of age 
  • T2D
  • HbA1c ≥7.0% to ≤9.5%
  • On a stable dose of dulaglutide (0.75 mg or 1.5 mg) ≥6 months
  • No treatment with OAMs or on a stable dose (≥3 months prior to first visit) of up to 3 OAMsa
  • T1D
  • Insulin use prior to screening 
  • History of reduction of the dose of dulaglutide due to intolerance without successful reescalation

Abbreviations: HbA1c = glycated hemoglobin; OAM = oral antihyperglycemic medication; SGLT2i = sodium-glucose co-transporter 2 inhibitor; T1D = type 1 diabetes; T2D = type 2 diabetes.

aThe OAMs could include any combination of metformin, sulfonylurea, and SGLT2i.

Study Design in SURPASS-SWITCH

In SURPASS-SWITCH, a total of 282 participants were randomly assigned to

  • dulaglutide 4.5 mg or MTD (n=143), or
  • tirzepatide 15 mg or MTD (n=139).2

SURPASS-SWITCH Study Design provides an overview of the study design and treatment dose escalation schemes. For details on treatment transition based on randomization, please refer to How Participants Escalated Dulaglutide or Switched to Tirzepatide in SURPASS-SWITCH.

SURPASS-SWITCH Study Design2

Figure 1 description: In SURPASS-SWITCH, participants with type 2 diabetes were randomly assigned to escalate dulaglutide dose to 4.5 mg or maximum tolerated dose or to switch to tirzepatide 15 mg or maximum tolerated dose. For both treatment groups, participants were required to escalate to the highest dosage strength and were directed to reduce the dosage to the last tolerated dosage in the event of gastrointestinal intolerability.

Abbreviations: MTD = maximum tolerated dose; T2D = type 2 diabetes. 

How Participants Escalated Dulaglutide or Switched to Tirzepatide in SURPASS-SWITCH2

If patients were randomly assigned to...

... then they

Dulaglutide 4.5 mg or MTD

continued weekly treatment with dulaglutide and escalated dosing every 4 weeks until 4.5 mg or MTD was achieved. 

Tirzepatide 15 mg or MTD

discontinued dulaglutide and initiated tirzepatide within 3 days of their next scheduled dose. The starting dose for tirzepatide was 2.5 mg once weekly for 4 weeks, escalated in 2.5 mg increments every 4 weeks until 15 mg or MTD was achieved.

Abbreviation: MTD = maximum tolerated dose. 

At week 40, 89.5% of dulaglutide-treated participants were able to achieve the maximum dose compared to 79.9% of tirzepatide-treated participants.2

Study Objectives in SURPASS-SWITCH

In SURPASS-SWITCH, the primary endpoint was change from baseline in HbA1c at week 40 between participants who escalated dulaglutide to 4.5 mg or MTD or switched to tirzepatide 15 mg or MTD.2

The key secondary endpoint was change from baseline in weight at week 40. Additional secondary endpoints at week 40 included, but were not limited to,

  • the proportion of participants achieving HbA1c <7%, ≤6.5%, and <5.7%
  • weight loss from baseline of ≥5%, ≥10%, and ≥15%, and
  • a composite of HbA1c ≤6.5% and weight loss ≥10% from baseline without hypoglycemia.2

Safety was assessed through treatment-emergent adverse events (TEAEs) reported by participants.2

Baseline Characteristics of Participants in SURPASS-SWITCH 

Baseline characteristics of SURPASS-SWITCH participants are summarized in Baseline Demographics and Characteristics in SURPASS-SWITCH.

Efficacy Results From SURPASS-SWITCH 

Primary and Key Secondary Efficacy Results 

In SURPASS-SWITCH, at week 40, the mean change from baseline in HbA1c was

  • -1.44% in participants who switched to tirzepatide15 mg or MTD, and
  • -0.67% in those who escalated to dulaglutide 4.5 mg or MTD (p<.001; see HbA1c and Weight Change From Baseline at Week 40 in SURPASS-SWITCH).2

Similarly, at week 40, the mean change from baseline in weight was

  • -10.5 kg in participants who switched to tirzepatide15 mg or MTD, and
  • -3.6 kg in those who escalated to dulaglutide 4.5 mg or MTD (p<.001; see HbA1c and Weight Change From Baseline at Week 40 in SURPASS-SWITCH).2
HbA1c and Weight Change From Baseline at Week 40 in SURPASS-SWITCH2

Figure 2 description: At week 40 in SURPASS-SWITCH, participants who switched from dulaglutide to tirzepatide 15 mg or MTD experienced greater reductions in HbA1c (p<.001). Tirzepatide-treated participants also experienced greater reductions in weight (p<.001) when compared with participants who escalated to dulaglutide 4.5 mg or MTD.

Abbreviations: ETD = estimated treatment difference; HbA1C = glycated hemoglobin; LSM = least squares mean; MMRM = mixed model for repeated measures; MTD = maximum tolerated dose. 

Notes: All values are LSM (standard error). Only subjects with non-missing baseline value and at least one non-missing post-baseline value of the response variable were included in analysis. All data for the treatment regimen estimand are analysis of covariance with multiple imputation by treatment for missing data (figure A and C). All data for the efficacy estimand are MMRM analysis (figure B and D).

Estimated treatment differences are LSM (95% CI) at 40 weeks for change in HbA1c.

p<.001 (two-sided) for superiority vs. dulaglutide, adjusted for multiplicity

Additional Secondary Efficacy Results 

Please refer to Participants Achieving HbA1c and Weight Loss Thresholds in the SURPASS-SWITCH Study for the proportion of participants in SURPASS-SWITCH with

  • HbA1c <7%, ≤6.5%, and <5.7% at week 40, or
  • weight loss from baseline of ≥5%, ≥10%, and ≥15%.

At week 40, 47.4% of participants treated with tirzepatide 15 mg or MTD had a composite endpoint of HbA1c ≤6.5% and weight loss ≥10% without hypoglycemia compared with 4.8% of those who escalated to dulaglutide 4.5 mg or MTD.2

Participants Achieving HbA1c and Weight Loss Thresholds in the SURPASS-SWITCH Study2

Figure 3 description: At week 40 in SURPASS-SWITCH, more participants who switched to tirzepatide 15 mg or MTD achieved HbA1c goals of <7%, ≤6.5%, and <5.7% and weight loss thresholds of ≥5%, ≥10%, and ≥15% when compared to participants who escalated to dulaglutide 4.5 or MTD. 

Abbreviations: HbA1c = glycated hemoglobin; MTD = maximum tolerated dose. 

Notes: All data are from logistic regression analysis with multiple imputation for missing data at week 40 using treatment-regimen estimand.

Safety Results From SURPASS-SWITCH 

Serious adverse events were reported by

  • 10 (7.2%) of tirzepatide-treated participants, and
  • 10 (7.0%) of dulaglutide-treated participants.2

The most commonly reported treatment-emergent adverse events (TEAEs) were nausea and diarrhea.2

One tirzepatide-treated participant discontinued study due to gastrointestinal AEs, while no dulaglutide-treated participants discontinued study due to gastrointestinal AEs (Adverse Events in the SURPASS-SWITCH Study).2

One death occurred in each group, neither were considered to be related to the study treatment by the investigators.2

There were no events of severe hypoglycemia reported in either treatment group.2

Adverse Events in the SURPASS-SWITCH Study2

Eventsa

Tirzepatide 15 mg or MTD
N=139

Dulaglutide 4.5 mg or MTD
N=143

Participants with any SAEs

10 (7.2)

10 (7.0)

Participants with AEs leading to discontinuation of study

2 (1.4) 

1 (0.7) 

Participants with GI disorders leading to study discontinuation 

1 (0.7) 

0 (0) 

Deathb

1 (0.7) 

1 (0.7) 

Hypoglycemia AEs 

Hypoglycemia, blood glucose level <54 mg/dL or <3 mmol/L

8 (5.8) 

4 (2.8) 

Hypoglycemia, blood glucose level ≥54 and <70 mg/dL or ≥3 mmol/L and <3.89 mmol/L

25 (18.0)

12 (8.4) 

Severe hypoglycemiac

0 (0.0)

0 (0.0)

Abbreviations: AE = adverse event; GI = gastrointestinal; MTD = maximum tolerated dose; SAE = serious adverse event.

aData are n (%).

bDeaths were also included as SAEs and discontinuations due to AEs.

cSevere hypoglycemia was an altered mental or physical status requiring assistance of another person to administer a carbohydrate, glucagon, or other resuscitative actions for the treatment of hypoglycemia.

Switching From a GLP-1 RA to Tirzepatide in SURPASS-SWITCH-2

SURPASS-SWITCH-2 is a phase 4 clinical trial that evaluates glycemic outcomes, body weight, and adverse events (AEs) that occur in the first 12 weeks following a switch from a GLP-1 RA directly to tirzepatide 5 mg, omitting the 2.5 mg initiation dose.3

Participants in this study had T2D and were on a stable dose of either semaglutide, dulaglutide, or liraglutide prior to enrollment into the trial.3

SURPASS-SWITCH-2 was an open-label, single-arm, multicenter trial in the United States. A control arm was omitted from the study design since the short 12-week duration would not provide adequate insight into comparative efficacy and for additional operational efficiency.3,4

Key Inclusion and Exclusion Criteria in SURPASS-SWITCH-2

Key inclusion and exclusion criteria for the SURPASS-SWITCH-2 study are presented in SURPASS-SWITCH-2 Phase 4 Study in Adults With T2D: Key Inclusion and Exclusion Criteria.

SURPASS-SWITCH-2 Phase 4 Study in Adults With T2D: Key Inclusion and Exclusion Criteria3

Key Inclusion Criteria

Key Exclusion Criteria

  • ≥18 years of age
  • T2D
  • HbA1c ≥6.5% to ≤9.0%
  • BMI ≥25 kg/m2
  • On stable treatment dose of 1 GLP-1 RA for ≥3 months:
    • liraglutide 1.2 or 1.8 mg once daily
    • dulaglutide 0.75, 1.5, 3, or 4.5 mg once weekly
    • semaglutide 0.5, 1, or 2 mg once weekly
  • No treatment with OAM or on stable doses (≥3 months before screening) of up to 3 OAMsa
  • T1D
  • History of
    • proliferative diabetic retinopathy, diabetic maculopathy, or nonproliferative diabetic retinopathy that requires acute treatment
    • ketoacidosis or hyperosmolar state or coma
    • severe hypoglycemia or hypoglycemia unawareness within the 6 months
    • chronic or acute pancreatitis
  • High risk for CV disease or a history of
    • myocardial infarction
    • percutaneous coronary revascularization procedure
    • carotid stenting or surgical revascularization
    • nontraumatic amputation
    • peripheral vascular procedure
    • cerebrovascular accident
    • hospitalization for CHF
  • NYHA Functional Classification Class IV CHF

Abbreviations: BMI = body mass index; CHF = congestive heart failure; CV = cardiovascular; GLP-1 = glucagon-like peptide-1; HbA1c = glycated hemoglobin; NYHA = New York Heart Association; OAM = oral antidiabetic medication; RA = receptor agonist; SGLT-2i = sodium-glucose cotransporter-2 inhibitor; T1D = type 1 diabetes; T2D = type 2 diabetes.

aThe OAMs could include metformin, SGLT-2i, thiazolidinediones, or α-glucosidase inhibitors.

Study Design in SURPASS-SWITCH-2

In SURPASS-SWITCH-2, a total of 152 participants across the United States received treatment with tirzepatide 5 mg once weekly with no dose escalation. Of these, 140 participants were included in efficacy analyses. All participants switched treatment from a prior GLP-1 RA directly to tirzepatide 5 mg. The tirzepatide 2.5 mg initiation dose was omitted (SURPASS-SWITCH-2 Study Design).3

SURPASS-SWITCH-2 Study Design3,5

Figure 1 description: SURPASS-SWITCH-2 had 2 study periods. Period 1 consisted of a 3-week screening period, which included a continuous glucose monitoring assessment while participants continued stable dose therapy with their baseline glucagon-like peptide-1 receptor agonist (eg, semaglutide, liraglutide, or dulaglutide). In period 2, participants switched to treatment with tirzepatide 5 mg once weekly, with additional continuous glucose monitoring performed at weeks 4 and 12. The study concluded after 12 weeks of tirzepatide 5 mg treatment. There was no safety follow-up period.

Abbreviations: CGM = continuous glucose monitoring; GLP-1 RA = glucagon-like peptide-1 receptor agonist; QW = once weekly; SC = subcutaneous.

How Participants Switched From Semaglutide, Dulaglutide, or Liraglutide to Tirzepatide in SURPASS-SWITCH -23

If participants entered the study on...

... then they took the last dose of the GLP-1 RA 

Semaglutide

at least 3 days but no longer than 10 days before their first tirzepatide 5 mg dose.

Dulaglutide

at least 3 days but no longer than 10 days before their first tirzepatide 5 mg dose.

Liraglutide

up to the day before their first tirzepatide 5 mg dose.

Abbreviation: GLP-1 RA = glucagon-like peptide-1 receptor agonist. 

Study Objectives in SURPASS-SWITCH-2

The primary endpoint was change from baseline in glycated hemoglobin (HbA1c) at 12 weeks after switching from a stable dose of GLP-1 RA to tirzepatide 5 mg.3

Secondary endpoints included change from baseline in

  • fasting serum glucose (FSG) at week 12
  • body weight at week 12, and
  • continuous glucose monitoring (CGM)-derived glucose levels time above range (TAR) at weeks 4 and 12.3

Tolerability and safety were also assessed through the reporting of AEs.3

Baseline Characteristics in SURPASS-SWITCH-2

Baseline characteristics of SURPASS-SWITCH-2 participants who switched from a GLP-1 RA to tirzepatide 5 mg are summarized in Baseline Demographics and Characteristics in SURPASS-SWITCH-2.

Efficacy Results From SURPASS-SWITCH-2

As presented in SURPASS-SWITCH-2 Primary and Secondary Endpoints at Week 12, participants on stable GLP-1 RA doses who switched directly to tirzepatide 5 mg showed significant reductions from baseline to week 12 (p<.001) in 

  • HbA1c
  • FSG
  • body weight, and
  • TAR (>10mmol/L [180 mg/dL] by CGM).3

Significant reductions from baseline (p<.001) in HbA1c (Change in HbA1c Over Time After Switching to Tirzepatide 5 mg Based on Prior GLP-1 RA) and weight (Change in Body Weight Over Time After Switching to Tirzepatide 5 mg Based on Prior GLP-1 RA) were also observed in a subgroup analysis of participants who switched to tirzepatide 5 mg from prior stable doses of semaglutide or dulaglutide.5

SURPASS-SWITCH-2 Primary and Secondary Endpoints at Week 123

Parametera

Tirzepatide 5 mg
N=140

HbA1c, %

Baseline

7.39

Week 12

6.96

CFB

-0.43***

FSG, mmol/L (mg/dL)

Baseline

7.79 (140.49)

Week 12

7.39 (132.85)

CFB

-0.44 (-7.83)**

Body weight, kg

Baseline

100.42

Week 12

98.27

CFB

-2.15***

TAR >10 mmol/L (180 mg/dL) by CGM, %

Baseline

21.9

Week 12

14.58

CFB

-7.37***

Abbreviations: CFB = change from baseline; CGM = continuous glucose monitoring; FSG = fasting serum glucose; HbA1c = glycated hemoglobin; mITT = modified intention-to-treat; MMRM = mixed-effects model for repeated measures; TAR = time above range.

***p<.001, **p<.01 versus baseline.

Note: Data are from MMRM analysis of mITT population. The efficacy analysis set includes all participants who took at least 1 dose of study drug, excluding participants who were inadvertently enrolled and data after treatment discontinuation.

aData are presented as least squares mean.

Change in HbA1c Over Time After Switching to Tirzepatide 5 mg Based on Prior GLP-1 RA5

Figure 2 description: Participants who switched from stable doses of semaglutide or dulaglutide to tirzepatide 5 mg experienced significant reductions in glycated hemoglobin over 12 weeks (p<.001). 

Abbreviations: GLP-1 RA = glucagon-like peptide-1 receptor agonist; HbA1c = glycated hemoglobin; mITT = modified intention-to-treat; MMRM = mixed-effects model for repeated measures.

Notes: Data presented are least squares means ± SE. MMRM analysis, mITT population (efficacy analysis set). Assessment of participants on liraglutide at baseline was performed but n=3, so results are not displayed.

***p<0.001 from baseline. 

Change in Body Weight Over Time After Switching to Tirzepatide 5 mg Based on Prior GLP-1 RA5

Figure 3 description: Participants who switched from stable doses of semaglutide or dulaglutide to tirzepatide 5 mg experienced significant reductions in body weight over 12 weeks (p<.001).

Abbreviations: GLP-1 RA = glucagon-like peptide-1 receptor agonist; mITT = modified intention-to-treat; MMRM = mixed-effects model for repeated measures.

Notes: Data presented are least squares mean ± SE. MMRM analysis, mITT population (efficacy analysis set). Assessment of participants on liraglutide at baseline was performed but n=3, so results are not displayed.

***p<0.001 from baseline. 

Safety Results From SURPASS-SWITCH-2

Out of 152 participants included in safety analyses for SURPASS-SWITCH-2, 20 (13.2%) participants reported gastrointestinal AEs. Of these,

  • 18 (11.8%) were mild severity, and
  • 2 (1.3%) were moderate severity.3

Three (2.0%) participants discontinued tirzepatide due to AEs (SURPASS-SWITCH-2 Treatment-Emergent Adverse Events).3

There were no deaths or events of severe hypoglycemia during the trial. Severe hypoglycemia was defined as altered mental or physical status requiring assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions for the treatment of hypoglycemia.3

SURPASS-SWITCH-2 Treatment-Emergent Adverse Events3,5

Eventsa

Tirzepatide 5 mg
(N=152)

Participants with ≥1 TEAE

54 (35.5)

Serious AEs

1 (0.7)

Deaths

0

AEs leading to treatment discontinuationb

3 (2.0)

GI AEs leading to treatment discontinuation

 2 (1.3)

Participants with GI disorders

20 (13.2)

GI disorders with mild severity

18 (11.8)

GI disorders with moderate severityc

2 (1.3)

Abbreviations: AE = adverse event; GI = gastrointestinal; mITT = modified intention-to-treat; TEAE = treatment-emergent adverse event.

aData are presented as n (%) from the mITT population (safety analysis set).

bTwo participants were considered inadvertently enrolled and had an AE that led to discontinuation.

cOne participant had moderate diarrhea and another had moderate constipation/dyspepsia.

Enclosed Prescribing Information

MOUNJARO® (tirzepatide) injection, for subcutaneous use, Lilly

References

The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).

1Mounjaro [package insert]. Indianapolis, IN: Eli Lilly and Company; 2024.

2Billings LK, Winnie L, Sharma P, et al. Comparison of dose escalation versus switching to tirzepatide among people with type 2 diabetes inadequately controlled on lower doses of dulaglutide: a randomized clinical trial. Ann Intern Med. Published online April 4, 2025. https://doi.org/10.7326/ANNALS-24-03849

3Jabbour S, Paik JS, Aleppo G, et al. Switching to tirzepatide 5 mg from glucagon-like peptide-1 receptor agonists: clinical expectations in the first 12 weeks of treatment. Endocr Pract. 2024;30(8):701-709. https://doi.org/10.1016/j.eprac.2024.05.005

4Data on file, Eli Lilly and Company and/or one of its subsidiaries.

5Jabbour S, Paik JS, Aleppo G, et al. Switching to tirzepatide 5 mg from GLP-1 RAs: clinical expectations in the first 12 weeks of treatment. Poster presented at: 33rd Annual Meeting of the American Association of Clinical Endocrinology (AACE); May 9-11, 2024; New Orleans, LA.

Appendix: Baseline Demographics and Characteristics in SURPASS-SWITCH and SURPASS-SWITCH-2

Baseline Demographics and Characteristics in SURPASS-SWITCH

In SURPASS-SWITCH, demographics and clinical characteristics were similar across the treatment groups with a mean

  • duration of diabetes of 11.2 years 
  • HbA1c of 7.82%, and
  • weight of 96.9 kg.2
Baseline Demographics and Characteristics in the SURPASS-SWITCH Study2

Characteristica

Tirzepatide 15 mg or MTD
N=139
 

Dulaglutide 4.5 mg or MTD 
N=143

Total
N=282
 

Age, years 

57.9 (9.8) 

57.3 (10.0) 

57.6 (9.8) 

Sex, n (%)b

Male

75 (54.0) 

71 (49.7)

146 (51.8) 

Female

64 (46.0) 

72 (50.3) 

136 (48.2)

Ethnicity, n (%)cd

Hispanic or Latino 

18 (50.0)

14 (42.4) 

32 (46.4) 

Not Hispanic or Latino

18 (50.0) 

19 (57.6) 

37 (53.6)

Weight, kg 

98.0 (20.8)

95.8 (20.3) 

96.9 (20.5)

BMI, kg/m2

34.7 (6.2) 

34.0 (6.5)

34.3 (6.3) 

Duration of T2D, years

11.1 (6.9) 

11.3 (7.1) 

11.2 (7.0) 

FSG, mg/dL 

150.0 (36.6)

156.2 (45.6) 

153.2 (41.4) 

HbA1c, % 

7.82 (0.69) 

7.82 (0.73)

7.82 (0.71) 

Concomitant OAMs

None 

5 (3.6)

8 (5.6) 

13 (4.6) 

Metformin alone

59 (42.4)

52 (36.4) 

111 (39.4) 

SGLT2 inhibitor alone 

2 (1.4) 

7 (4.9) 

9 (3.2) 

Sulfonylurea alone 

2 (1.4) 

3 (2.1) 

5 (1.8) 

Two OAMs

63 (45.3) 

60 (42.0) 

123 (43.6) 

Three OAMs 

8 (5.8) 

13 (9.1) 

21 (7.4) 

Baseline dulaglutide dose, n (%) 

0.75 mg QW 

47 (33.8) 

47 (32.9) 

94 (33.3) 

1.5 mg QW 

92 (66.2) 

96 (67.1) 

188 (66.7) 

Abbreviations: BMI = body mass index; FSG = fasting serum glucose; HbA1c = glycated hemoglobin; MTD = maximum tolerated dose; OAM = oral antihyperglycemic medication; QW = weekly; SGLT2 = sodium-glucose co-transporter 2; T2D = type 2 diabetes.

aData are mean (SD) or n (%) and include all randomized participants unless otherwise stated.

bSex was self-reported.

cEthnicity was self-reported.

dOnly includes responses from US sites.

Baseline Demographics and Characteristics in SURPASS-SWITCH-2

The overall study population had a(n) 

  • average age of 58.3 years
  • HbA1c of 7.39%
  • weight of 100.55 kg, and 
  • body mass index of 35.18 kg/m2.3
Baseline Demographics and Characteristics3,4

Characteristica

Study Population
 (Tirzepatide 5 mg)
N=140b

Age, y 

58.3±10.3

Female, n (%)

77 (55.0)

Duration of T2D, y

12.4±7.4

Race, n (%)

American Indian or Alaska Native

2 (1.4)

Asian 

9 (6.4)

Black or African American 

21 (15.0)

White 

108 (77.1)

HbA1c, %

7.39±0.66

Fasting serum glucose, mmol/L (mg/dL)

7.79±1.85 (140.24±33.25)

Body mass index, kg/m2  

35.18±6.74

Weight, kg 

100.55±22.60

Baseline GLP-1 RA, n (%)c

Semaglutide

77 (55.0)

0.5 mg QW

20 (26.0)

1.0 mg QW

39 (50.6)

2.0 mg QW

18 (23.4) 

Dulaglutide

59 (42.1)

0.75 mg QW

15 (25.4) 

1.5 mg QW

21 (35.6)

3.0 mg QW

11 (18.6)

4.5 mg QW

12 (20.3)

Liraglutide

3 (2.1)

1.2 mg QD

1 (33.3)

1.8 mg QD

2 (66.7)

Participants with ≥1 concomitant OAM, n (%)

110 (78.6)

Metformin

89 (63.6)

SGLT-2 inhibitors

48 (34.3)

Thiazolidinediones

12 (8.6)

Metformin/SGLT-2 inhibitor combination therapy

5 (3.6)

Abbreviations: GLP-1 RA = glucagon-like peptide-1 receptor agonist; HbA1c = glycated hemoglobin; OAM = oral antihyperglycemic medication; QD = once daily; QW = once weekly; SGLT-2 = sodium-glucose cotransporter-2; T2D = type 2 diabetes.

aData are presented as mean ± SD unless otherwise noted.

bExcludes inadvertently enrolled participants.

cOne participant had a missing value for the baseline GLP-1 RA.

Date of Last Review: February 28, 2025

Additional related information:

  • How should Mounjaro® (tirzepatide) doses be increased?
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