Lilly adds liver fat, CGM blood sugar data to mountain of evidence on hot diabetes prospect tirzepatide

Eli Lilly has added to the mountain of data it is piling up in support of diabetes prospect tirzepatide. The latest additions to the pile come from two phase 3 sub-studies that linked the dual GIP/GLP-1 agonist to improvements in patients using continuous glucose monitors and reductions in liver fat.

Lilly presented top-line data from the phase 3, SURPASS-3, early this year, revealing that tirzepatide had triggered steeper drops in a measure of blood sugar than insulin degludec, the ultralong-acting basal insulin analogue sold by Novo Nordisk as Tresiba. With that win under its belt, Lilly rolled into the European Association for the Study of Diabetes' annual meeting armed with more data from the trial.

In an MRI sub-study, Lilly looked at changes in liver fat content and abdominal adipose tissue. At all three doses, tirzepatide drove greater reductions in the various fat types than insulin degludec. The finding points to the potential for tirzepatide to address a risk factor in Type 2 diabetics.

"Increased ectopic fat—such as liver fat or visceral adipose tissue—is commonly seen in adults with Type 2 diabetes and is associated with an inflammatory response and increased cardiometabolic risk," Amalia Gastaldelli, research director of the cardiometabolic risk unit at the CNR Institute of Clinical Physiology in Italy, said in a statement. "We are encouraged by the robust reductions in liver fat content and abdominal adipose tissue observed with all three doses of tirzepatide.”

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Across the three doses of tirzepatide, Lilly saw relative reductions in baseline liver fat content of 30% to 47%, compared to an 11% drop in recipients of insulin degludec. Between 67% and 81% of people on tirzepatide experienced a 30% or greater reduction in liver fat, depending on the dose, compared to 32% of their peers on the control drug. 

Lilly presented the results alongside data from another SURPASS-3 sub-study. The second sub-study assessed the effect of tirzepatide in adult Type 2 diabetics with continuous glucose monitors. In the subpopulation, participants in the two higher tirzepatide dose cohorts spent around six more hours in the 70- to 140-mg/dL blood glucose range in a 24-hour period than their peers on insulin degludec.

The sub-study analyses add to the evidence Lilly has generated across a series of clinical trials that have pitted tirzepatide against different controls and in different patient populations. Lilly released top-line data from the fifth phase 3 in the sequence in May, putting it on track to bring the drug to market in diabetes next year and forge ahead with plans to target conditions including nonalcoholic steatohepatitis and obesity.