Thirzepatide. A novelty in the treatment of obesity - literature review
DOI:
https://doi.org/10.12775/QS.2024.15.52005Keywords
tirzepatide, obesity, obesity treatmentAbstract
Introduction
Obesity results from a complex interplay of environmental, genetic, and behavioral factors, making it challenging to treat. Globally, the prevalence of obesity has tripled over the past fifty years. The WHO reports that 60% of Europeans are overweight or obese mainly due to sedentary lifestyles and poor dietary habits. Effective treatment of obesity requires a combination of lifestyle modifications, including diet and physical activity, and pharmacological interventions. In 2023 a new drug - tirzepatide was registered. The purpose of this study is to discuss the mechanisms of action of tirzepatide, its safety and its effectiveness in body mass reduction, as well as its comparison with other available drug.
Aim of the Study
The purpose of this study is to provide a comprehensive review of current treatments for obesity, with particular emphasis on the role of recent development in pharmacotherapy - the introduction of tirzeptide. The study aims to discuss the mechanisms of action of tirzepatide, its safety and its effectiveness in body mass reduction, as well as its comparison with semaglutide.
Materials and methods
A review of the literature collected in the PubMed database was performed to gather information found under the keywords: tirzepatide, obesity, obesity treatment
Conclusions
Studies have shown that tirzepatide is more effective in weight loss than placebo and semaglutide, and reduces cardiovascular and metabolic risks. Furthermore, it does not increase the risk of serious adverse events or mortality compared to placebo, and its main side effects manifested by gastrointestinal symptoms are described as mild to moderate.
References
M. Al Roomy et al., “Therapeutic advances in obesity management: an overview of the therapeutic interventions.,” Front. Endocrinol. (Lausanne)., vol. 15, p. 1364503, 2024, https://doi.org/10.3389/fendo.2024.1364503.
M. Blüher, “Obesity: global epidemiology and pathogenesis.,” Nat. Rev. Endocrinol., vol. 15, no. 5, pp. 288–298, May 2019, https://doi.org/10.1038/s41574-019-0176-8.
C. Boutari and C. S. Mantzoros, “A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on.,” Metabolism: clinical and experimental, vol. 133. United States, p. 155217, Aug. 2022. https://doi.org/10.1016/j.metabol.2022.155217.
A. Okunogbe, R. Nugent, G. Spencer, J. Powis, J. Ralston, and J. Wilding, “Economic impacts of overweight and obesity: current and future estimates for 161 countries.,” BMJ Glob. Heal., vol. 7, no. 9, Sep. 2022, https://doi.org/10.1136/bmjgh-2022-009773.
S. Cai et al., “Association of the Weight-Adjusted-Waist Index With Risk of All-Cause Mortality: A 10-Year Follow-Up Study.,” Front. Nutr., vol. 9, p. 894686, 2022, https://doi.org/10.3389/fnut.2022.894686.
G. Whitlock et al., “Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies.,” Lancet (London, England), vol. 373, no. 9669, pp. 1083–1096, Mar. 2009, https://doi.org/10.1016/S0140-6736(09)60318-4.
S. Djalalinia, M. Qorbani, N. Peykari, and R. Kelishadi, “Health impacts of Obesity.,” Pakistan J. Med. Sci., vol. 31, no. 1, pp. 239–242, 2015, https://doi.org/10.12669/pjms.311.7033.
C. B. Weir and A. Jan, “BMI Classification Percentile And Cut Off Points.,” Treasure Island (FL), 2024.
R. Z. Sharaiha, S. Shikora, K. P. White, G. Macedo, J. Toouli, and L. Kow, “Summarizing Consensus Guidelines on Obesity Management: A Joint, Multidisciplinary Venture of the International Federation for the Surgery of Obesity & Metabolic Disorders (IFSO) and World Gastroenterology Organisation (WGO).,” J. Clin. Gastroenterol., vol. 57, no. 10, pp. 967–976, 2023, https://doi.org/10.1097/MCG.0000000000001916.
G. A. Bray, G. Frühbeck, D. H. Ryan, and J. P. H. Wilding, “Management of obesity.,” Lancet (London, England), vol. 387, no. 10031, pp. 1947–1956, May 2016, https://doi.org/10.1016/S0140-6736(16)00271-3.
L. Raiman, R. Amarnani, M. Abdur-Rahman, A. Marshall, and S. Mani-Babu, “The role of physical activity in obesity: let’s actively manage obesity.,” Clin. Med., vol. 23, no. 4, pp. 311–317, Jul. 2023, https://doi.org/10.7861/clinmed.2023-0152.
A. Petridou, A. Siopi, and V. Mougios, “Exercise in the management of obesity.,” Metabolism., vol. 92, pp. 163–169, Mar. 2019, https://doi.org/10.1016/j.metabol.2018.10.009.
J. S. Baker, R. Supriya, F. Dutheil, and Y. Gao, “Obesity: Treatments, Conceptualizations, and Future Directions for a Growing Problem.,” Biology (Basel)., vol. 11, no. 2, Jan. 2022, https://doi.org/10.3390/biology11020160.
S. Wharton et al., “Obesity in adults: a clinical practice guideline.,” C. Can. Med. Assoc. J. = J. l’Association medicale Can., vol. 192, no. 31, pp. E875–E891, Aug. 2020, https://doi.org/10.1503/cmaj.191707.
M. Olszanecka-Glinianowicz et al., “Obesity in Adults: Position Statement of Polish Association for the Study on Obesity, Polish Association of Endocrinology, Polish Association of Cardiodiabetology, Polish Psychiatric Association, Section of Metabolic and Bariatric Surgery of the Associat,” Nutrients, vol. 15, no. 7, Mar. 2023, https://doi.org/10.3390/nu15071641.
E. Melson, U. Ashraf, D. Papamargaritis, and M. J. Davies, “What is the pipeline for future medications for obesity?,” Int. J. Obes. (Lond)., Feb. 2024, https://doi.org/10.1038/s41366-024-01473-y.
S. L. Anderson and J. C. Marrs, “Tirzepatide for type 2 diabetes.,” Drugs Context, vol. 12, 2023, https://doi.org/10.7573/dic.2023-6-1.
“Naltrexone/bupropion for obesity.,” Drug Ther. Bull., vol. 55, no. 11, pp. 126–129, Nov. 2017, https://doi.org/10.1136/dtb.2017.11.0550.
F. L. Greenway et al., “Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.,” Lancet (London, England), vol. 376, no. 9741, pp. 595–605, Aug. 2010, https://doi.org/10.1016/S0140-6736(10)60888-4.
S. L. Greig and G. M. Keating, “Naltrexone ER/Bupropion ER: A Review in Obesity Management.,” Drugs, vol. 75, no. 11, pp. 1269–1280, Jul. 2015, https://doi.org/10.1007/s40265-015-0427-5.
M. P. Curran and L. J. Scott, “Orlistat: a review of its use in the management of patients with obesity.,” Drugs, vol. 64, no. 24, pp. 2845–2864, 2004, https://doi.org/10.2165/00003495-200464240-00010.
K. M. Gadde, C. K. Martin, H.-R. Berthoud, and S. B. Heymsfield, “Obesity: Pathophysiology and Management.,” J. Am. Coll. Cardiol., vol. 71, no. 1, pp. 69–84, Jan. 2018, https://doi.org/10.1016/j.jacc.2017.11.011.
A. M. Chao, J. S. Tronieri, A. Amaro, and T. A. Wadden, “Semaglutide for the treatment of obesity.,” Trends Cardiovasc. Med., vol. 33, no. 3, pp. 159–166, Apr. 2023, https://doi.org/10.1016/j.tcm.2021.12.008.
Z. Xie, S. Yang, W. Deng, J. Li, and J. Chen, “Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review.,” Clin. Epidemiol., vol. 14, pp. 1463–1476, 2022, https://doi.org/10.2147/CLEP.S391819.
T. Coskun et al., “LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept.,” Mol. Metab., vol. 18, pp. 3–14, Dec. 2018, https://doi.org/10.1016/j.molmet.2018.09.009.
M. A. Nauck and J. J. Meier, “Incretin hormones: Their role in health and disease.,” Diabetes. Obes. Metab., vol. 20 Suppl 1, pp. 5–21, Feb. 2018, https://doi.org/10.1111/dom.13129.
L. L. Baggio and D. J. Drucker, “Biology of incretins: GLP-1 and GIP.,” Gastroenterology, vol. 132, no. 6, pp. 2131–2157, May 2007, https://doi.org/10.1053/j.gastro.2007.03.054.
T. Min and S. C. Bain, “The Role of Tirzepatide, Dual GIP and GLP-1 Receptor Agonist, in the Management of Type 2 Diabetes: The SURPASS Clinical Trials.,” Diabetes Ther. Res. Treat. Educ. diabetes Relat. Disord., vol. 12, no. 1, pp. 143–157, Jan. 2021, https://doi.org/10.1007/s13300-020-00981-0.
S. Kagdi, S. A. Lyons, and J. L. Beaudry, “The interplay of glucose-dependent insulinotropic polypeptide in adipose tissue.,” J. Endocrinol., vol. 261, no. 3, Jun. 2024, https://doi.org/10.1530/JOE-23-0361.
R. J. Samms, M. P. Coghlan, and K. W. Sloop, “How May GIP Enhance the Therapeutic Efficacy of GLP-1?,” Trends Endocrinol. Metab., vol. 31, no. 6, pp. 410–421, Jun. 2020, https://doi.org/10.1016/j.tem.2020.02.006.
J. Rosenstock et al., “Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial.,” Lancet (London, England), vol. 398, no. 10295, pp. 143–155, Jul. 2021, https://doi.org/10.1016/S0140-6736(21)01324-6.
J. P. Frías et al., “Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes.,” N. Engl. J. Med., vol. 385, no. 6, pp. 503–515, Aug. 2021, https://doi.org/10.1056/NEJMoa2107519.
A. M. Jastreboff et al., “Tirzepatide Once Weekly for the Treatment of Obesity.,” N. Engl. J. Med., vol. 387, no. 3, pp. 205–216, Jul. 2022, https://doi.org/10.1056/NEJMoa2206038.
J. P. Frias et al., “Efficacy and safety of LY3298176, a novel dual GIP and GLP-1 receptor agonist, in patients with type 2 diabetes: a randomised, placebo-controlled and active comparator-controlled phase 2 trial.,” Lancet (London, England), vol. 392, no. 10160, pp. 2180–2193, Nov. 2018, https://doi.org/10.1016/S0140-6736(18)32260-8.
T. Karagiannis et al., “Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: a systematic review and meta-analysis.,” Diabetologia, vol. 65, no. 8, pp. 1251–1261, Aug. 2022, https://doi.org/10.1007/s00125-022-05715-4.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Katarzyna Wiśniewska, Julita Gmitrzuk, Zuzanna Malinka, Anna Jachymek, Martyna Opatowska, Joanna Jakubiec, Tomasz Kucharski, Marta Piotrowska
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 122
Number of citations: 0
