Real-World Clinical Evidence of Tirzepatide for Metabolic Abnormalities in Subjects With Type 2 Diabetes: The Multicenter Retrospective Observational Hokkaido-TZP Study.

PubMed7 Apr 2026·Diabetes, obesity & metabolism● 6/10i

Real-World Clinical Evidence of Tirzepatide for Metabolic Abnormalities in Subjects With Type 2 Diabetes: The Multicenter Retrospective Observational Hokkaido-TZP Study.

Maruyama F, Kitsunai H, Kitao N, Wakabayashi Y, Ito M et al.

Tirzepatide reduced HbA1c by 1.07% and body weight by 3.1 kg over 6 months in adults with type 2 diabetes in Japanese real-world practice. Multicenter retrospective observational study of 828 patients treated for 6+ months across 10 centers in Hokkaido. The efficacy remained consistent even in patients switching from existing incretin-based medications, providing first real-world evidence of tirzepatide's effectiveness after GLP-1 failure. Discontinuation rate was 5.4% due to adverse events or other clinical reasons.

Strategic signal

This real-world evidence strengthens Eli Lilly's positioning against Novo Nordisk's semaglutide by demonstrating sustained efficacy in incretin-experienced patients. Japanese real-world data supports global reimbursement discussions, particularly important as Japan's Central Social Insurance Medical Council evaluates dual incretin therapies. The consistent efficacy in switcher populations provides Lilly with clinical ammunition for sequential therapy discussions with endocrinologists already prescribing GLP-1 RAs.

GLP-1Type 2 diabetesReal-world evidenceEli Lilly Novo Nordisk

Original Abstract

AIMS: Tirzepatide has demonstrated potent glucose-lowering efficacy and metabolic benefits in subjects with type 2 diabetes (T2D) in Phase III clinical trials. However, its efficacy in real-world clinical practice, particularly among patients receiving various antidiabetic therapies, remains to be elucidated. MATERIALS AND METHODS: This multicenter retrospective observational study evaluated subjects with T2D who were treated with tirzepatide for ≥ 6 months across 10 medical centers in Hokkaido, Japan. Primary endpoints included changes in glycated haemoglobin and other metabolic parameters after 6 months of treatment with tirzepatide, alongside adverse events leading to discontinuation of tirzepatide. RESULTS: Of the 828 subjects analysed (mean age 55.6 ± 12.5 years; mean body mass index 30.6 ± 5.8), 81.3% were treated with incretin-based medications at baseline. Tirzepatide was discontinued in 45 subjects because of adverse events, personal preference or other clinical reasons. Significant improvements were observed in both glycated haemoglobin (-1.07%, 95% CI -1.16, -0.98; baseline 7.82% ± 1.59%, p < 0.001) and body weight (-3.1 kg, 95% CI -3.4, -2.8; baseline 83.8 ± 18.5 kg, p < 0.001). This efficacy was consistent even in patients switching from incretin-based medications. CONCLUSIONS: Tirzepatide demonstrated robust clinical efficacy and a favourable safety profile in a real-world clinical setting, regardless of whether incretin-based therapy had been administered previously.

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