Switching from Dulaglutide to Tirzepatide in T2D—Subgroup Analyses of the SURPASS-SWITCH Trial

Introduction and Objective: This work investigates the potential benefits of switching from weekly dulaglutide (DU) to weekly tirzepatide (TZP) in adults with T2D across baseline subgroups from SURPASS-SWITCH. Methods: SURPASS-SWITCH was a Phase 4 trial enrolling adults with T2D and inadequate glycemic control treated with weekly DU (0.75 mg/1.5 mg) for at least 6 months plus 0-3 oral antihyperglycemic medications (OAMs). Participants were assigned 1:1 to escalate to DU 4.5 mg/maximally tolerated dose (MTD), or switch with escalation to TZP 15 mg/MTD. Treatment effect on HbA1c and BW were analyzed by baseline subgroups of HbA1c (≤8.5%, >8.5%), duration of T2D (≤5 years, >5-≤10 years, >10 years), baseline DU dose (0.75 mg, 1.5 mg), and duration of DU dose (<1 year, ≥1 year). Results: Switching to TZP versus escalating DU was associated with statistically significant reductions from baseline to week 40 in HbA1c and BW across all baseline subgroups. Conclusion: In SURPASS-SWITCH, switching to TZP 15 mg/MTD from DU 0.75 mg /1.5 mg was associated with significant and consistent improvements in HbA1c and weight reductions versus DU across all baseline subgroups. For those not at treatment goals across a range of baseline characteristics, switching to TZP may be a clinical option when current treatment plans are not yielding desired clinical outcomes. Disclosure: R. Violante: None. L. Rose: None. P. Sharma: None. K.K. Chivukula: Employee; Eli Lilly and Company. A. Kwan: Employee; Eli Lilly and Company.