Trial reportDiabetes, obesity & metabolism2025

Long-term efficacy and safety of tirzepatide in participants with type 2 diabetes with inadequate glycaemic control on metformin and/or sulfonylurea: Post-hoc analysis of SURPASS-4.

Haixia Guan, Hongwei Jiang, Huijuan Yuan, Jie Sun, Jiawei Xu, Linong Ji

Registry-linked trialAbstract readRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2025. The graph read 6 numbers from its abstract, feeding 2 cells of the map: it . It reports registered trial NCT03730662. Cited by 2 papers.

6numbers the graph read from it
2cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-11.40 · no effect
Reduction in body weighttirzepatide 5 mg vs insulin glarginefavours the treatment · obesity, t2dfeeds one cell of the map
Δ -7.60<0.001
Participants in the tirzepatide groups had significantly greater reduction in body weight (5 mg: -7.6 kg, 10 mg: -10.0 kg, 15 mg: -11.4 kg) compared with the insulin glargine group (2.1 kg) (p < 0.001).
Mean reduction in HbA1ctirzepatide 5 mg vs insulin glarginefavours the treatment · obesity, t2dfeeds one cell of the map
Δ -2.30<0.001
At Week 104, participants in the tirzepatide groups had significantly greater mean reduction in HbA1c (5 mg: -2.3%, 10 mg: -2.5%, 15 mg: -2.6%) compared with the insulin glargine group (-1.0%) (p < 0.001).
Reduction in body weighttirzepatide 10 mg vs insulin glarginefavours the treatment · obesity, t2dfeeds one cell of the map
Δ -10.0<0.001
Participants in the tirzepatide groups had significantly greater reduction in body weight (5 mg: -7.6 kg, 10 mg: -10.0 kg, 15 mg: -11.4 kg) compared with the insulin glargine group (2.1 kg) (p < 0.001).
Reduction in body weighttirzepatide 15 mg vs insulin glarginefavours the treatment · obesity, t2dfeeds one cell of the map
Δ -11.4<0.001
Participants in the tirzepatide groups had significantly greater reduction in body weight (5 mg: -7.6 kg, 10 mg: -10.0 kg, 15 mg: -11.4 kg) compared with the insulin glargine group (2.1 kg) (p < 0.001).
Mean reduction in HbA1ctirzepatide 15 mg vs insulin glarginefavours the treatment · obesity, t2dfeeds one cell of the map
Δ -2.60<0.001
At Week 104, participants in the tirzepatide groups had significantly greater mean reduction in HbA1c (5 mg: -2.3%, 10 mg: -2.5%, 15 mg: -2.6%) compared with the insulin glargine group (-1.0%) (p < 0.001).
Mean reduction in HbA1ctirzepatide 10 mg vs insulin glarginefavours the treatment · obesity, t2dfeeds one cell of the map
Δ -2.50<0.001
At Week 104, participants in the tirzepatide groups had significantly greater mean reduction in HbA1c (5 mg: -2.3%, 10 mg: -2.5%, 15 mg: -2.6%) compared with the insulin glargine group (-1.0%) (p < 0.001).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GIP/GLP-1 & amylin agonists×body weight & composition

No readable resultOpen on the map →What to test next →

29 readable studies in this cell: 27 favour the treatment, 1 find no difference, 1 favour the comparator.

Belief with this paper
1.00replicated · 19 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
This paper2,002 enrolled · 2018
Δ -11.4
Δ -17.3-18.1 to -16.6
NCT041846222,539 enrolled · 2019
Δ -13.5-14.6 to -12.5
NCT039879191,879 enrolled · 2019
Δ -1.70-2.60 to -0.70
NCT038829701,444 enrolled · 2019
Δ -9.80-10.8 to -8.80
NCT045379231,428 enrolled · 2020
Δ -10.7-11.5 to -9.90
Δ -10.4-11.2 to -9.50
NCT04657003938 enrolled · 2021
Δ -10.1-11.5 to -8.80
NCT04093752917 enrolled · 2019
Δ -6.50-7.40 to -5.60
NCT04660643783 enrolled · 2021
Δ -21.4-22.9 to -20.0
NCT05822830751 enrolled · 2023
Δ -6.50-8.10 to -4.90
NCT04847557731 enrolled · 2021
Δ -11.6-12.8 to -10.4
NCT03861052636 enrolled · 2019
Δ -5.20-6.40 to -4.10

GIP/GLP-1 & amylin agonists×glycemic control

No readable resultOpen on the map →What to test next →

24 readable studies in this cell: 21 favour the treatment, 3 find no difference, 0 favour the comparator.

Belief with this paper
0.88established · 15 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
This paper2,002 enrolled · 2018
Δ -2.50
NCT041846222,539 enrolled · 2019
Δ -0.33-0.36 to -0.30
NCT039879191,879 enrolled · 2019
Δ -0.51-0.64 to -0.38
NCT038829701,444 enrolled · 2019
Δ -0.86-1.00 to -0.72
NCT045379231,428 enrolled · 2020
Δ -1.10-1.24 to -0.97
NCT04093752917 enrolled · 2019
Δ -1.49-1.69 to -1.29
NCT04660643783 enrolled · 2021
Δ -8.92-10.4 to -7.43
NCT03861052636 enrolled · 2019
Δ -1.09-1.27 to -0.90
NCT04657016579 enrolled · 2021
Δ -11.2-13.5 to -8.80
NCT03954834478 enrolled · 2019
Δ -1.91-2.18 to -1.63
NCT04039503475 enrolled · 2019
Δ -1.66-1.88 to -1.43
NCT03131687318 enrolled · 2017
Δ -0.80-1.20 to -0.40
NCT05564039282 enrolled · 2022
Δ -0.90-1.10 to -0.69
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03730662 phase3completed

Efficacy and Safety of LY3298176 Once Weekly Versus Insulin Glargine in Patients With Type 2 Diabetes and Increased Cardiovascular Risk (SURPASS-4)

Ran2018Enrolled2,002Registered outcomes8Posted comparisons12ConditionsType 2 Diabetes MellitusArmsInsulin glargine, Tirzepatide
Open the trial in the graph
5 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Journal of pharmacopuncture · 2026
    Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

6 authors.

Haixia GuanDepartment of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China.
Hongwei JiangEndocrinology and Metabolism Center, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, People's Republic of China.
Huijuan YuanDepartment of Endocrinology and Metabolic Diseases, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.
Jie SunEli Lilly and Company, Shanghai, China.ORCID https://orcid.org/0009-0006-5321-6827
Jiawei XuEli Lilly and Company, Shanghai, China.
Linong JiDepartment of Endocrinology, Peking University People's Hospital, Beijing, People's Republic of China.ORCID https://orcid.org/0000-0003-1305-1598

Funding

Eli Lilly and Company
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aimTo evaluate the long-term efficacy and safety data at 104 weeks in tirzepatide-treated participants with type 2 diabetes who had inadequate glycaemic control on metformin and/or sulfonylurea. MATERIALS AND

methodsThis post-hoc analysis was based on the SURPASS-4 data (NCT03730662), a multicenter, Phase III trial. Participants were randomised to receive tirzepatide (5, 10, or 15 mg) or insulin glargine. The primary efficacy endpoint was change in HbA1c levels from baseline to 104 weeks. Key secondary endpoints were changes in body weight and the proportion of participants achieving HbA1c <7.0%. Safety endpoints included the incidence of treatment-emergent adverse events (AEs) and hypoglycaemia.

resultsThis post-hoc analysis included 1,500 participants. At Week 104, participants in the tirzepatide groups had significantly greater mean reduction in HbA1c (5 mg: -2.3%, 10 mg: -2.5%, 15 mg: -2.6%) compared with the insulin glargine group (-1.0%) (p < 0.001). Participants in the tirzepatide groups had significantly greater reduction in body weight (5 mg: -7.6 kg, 10 mg: -10.0 kg, 15 mg: -11.4 kg) compared with the insulin glargine group (2.1 kg) (p < 0.001). Significantly more participants in the tirzepatide group achieved HbA1c <7.0% compared with the insulin glargine group (p < 0.001). The incidence of hypoglycaemia was lower in the tirzepatide groups, and gastrointestinal AEs were mild or moderate in severity.

conclusionsTirzepatide significantly improved glycaemic control and body weight reduction compared to insulin glargine over 104 weeks in participants with type 2 diabetes inadequately controlled on metformin and/or sulfonylurea. The safety profile of tirzepatide was acceptable, with a lower incidence of hypoglycaemia than insulin glargine.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsMetforminAdultAgedBlood GlucoseBody WeightDrug Therapy, CombinationFemaleGlycated HemoglobinGlycemic ControlHumansHypoglycemiaInsulin GlargineMaleMiddle AgedBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulin GlargineMetforminSulfonylurea CompoundsTirzepatideoral antihyperglycaemic drugspost‐hoc analysisSURPASS‐4tirzepatidetype 2 diabetes

Identifiers

PMID40926359
PMCPMC12515763

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.