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Tirzepatide and Kidney Outcomes, with Hiddo Heerspink, PharmD, PhD

Hiddo Heerspink, PharmD, PhD, discusses a SURPASS-4 analysis examining kidney outcomes among patients receiving tirzepatide vs insulin glargine and provides perspective on the next steps for research as well as education.

Although SURMOUNT-1 data has taken centerstage at the American Diabetes Association (ADA) 82nd Scientific Sessions, new data from the SURPASS program has also received attention at the conference. A prespecified analysis of the SURPASS-4 trial, which compared tirzepatide against insulin glargine, results of the study indicate of use of tirzepatide was associated with a 41% reduction in risk for a composite endpoint of worsening chronic kidney disease among patients included in the trial.

Presented by Hiddo Heerspink, PharmD, PhD, the analysis included 1995 patients from SURPASS-4 who had received at least 1 dose of placebo or tirzepatide and had co-primary outcomes of interest, which were composite outcomes consisting of a decline of 40% or more in eGFR from baseline, renal death, and progression to end-stage renal disease analyzed with and without new-onset macroalbuminuria as an additional component.

At 104 weeks, use of tirzepatide was associated with a 41% reduction in risk of the first composite endpoint (HR, 0.59 [95% CI, 0.43-0.80]), which included new onset macroalbuminuria, and a 20% reduction in risk for the second composite outcome (HR, 0.80 [95% CI, 0.53-1.22]), which did not include new onset of macroalbuminuria. In subgroups analyses, risk of either primary composite outcome was consistent across all subgroups, including those with moderate or severely reduced kidney function, those at high risk for kidney-related outcomes, with or without baseline albuminuria at or exceeding 30 mg/g, and according to baseline SGLT2 inhibitor use.

To learn more about tirzepatide in patients with type 2 diabetes, Endocrinology Network caught up with Heerspink after his presentation at ADA 2022 and that conversation is the subject of the video below.