12-month weight-loss trajectories and predictors of response to tirzepatide under individualized dosing: A multicenter real-world study.
In a real-world setting, tirzepatide was associated with significant weight loss and high treatment persistence over 12 months, but long-term maintenance beyond this period is unclear.
Where it sits
this study against the rest of the tirzepatide corpusSummary and findings
This study evaluated the 12-month outcomes of tirzepatide in 249 adults with overweight or obesity under individualized dosing conditions. The mean weight loss was reported as 19.9 ± 8.6% at 12 months, with 68.3% of patients remaining on treatment. The study highlights treatment persistence and predictors of response but does not establish long-term weight maintenance.
Abstract
<h4>Background and aims</h4>Real-world evidence on 12-month treatment effectiveness and persistence with tirzepatide remains limited, particularly under individualized dosing and self-funded treatment conditions. We evaluated 12-month tirzepatide outcomes in routine clinical practice.<h4>Methods</h4>This was a multicenter, retrospective, observational real-world study including 249 adults with overweight or obesity treated with tirzepatide across 13 obesity practices in Greece. Treatment was entirely self-funded, and dose escalation was individualized rather than protocol driven. Treatment persistence, reasons for discontinuation, weight loss, dose trajectories, metabolic outcomes, and predictors of 12-month response were evaluated.<h4>Results</h4>At 12 months, 170/249 patients (68.3%) remained on treatment, 64 (25.7%) had confirmed discontinuation, and 15 (6.0%) were lost to follow-up. Among patients with available weight measurements, mean weight loss was 19.9 ± 8.6% at 12 months, with 88.9%, 50.0%, and 27.2% achieving ≥10%, ≥20%, and ≥25% weight loss, respectively. Mean tirzepatide dose at 12 months was 9.71 mg. Among 179 patients assessed at both 6 and 12 months, 70.4% experienced >2% additional weight loss during the second 6 months, whereas 10.1% experienced >2% weight regain. Six-month percentage weight loss was not significantly associated with additional weight loss between months 6 and 12 after multivariable adjustment (β = -0.110, P = 0.135). Among 139 participants who had not achieved ≥20% weight loss at month 6, early response demonstrated moderate discrimination for achieving this cumulative threshold at month 12 (AUC 0.760, 95% bootstrap CI 0.675-0.837), with an adjusted OR of 1.34 per additional percentage point of 6-month weight loss (P < 0.001).<h4>Conclusions</h4>In a fully self-funded real-world setting, tirzepatide was associated with substantial weight loss and high documented treatment persistence over 12 months. Six-month weight-loss response was associated with the likelihood of achieving ≥20% weight loss at 12 months. These findings do not establish long-term weight maintenance beyond the observation period.
Background
This paper addresses the effectiveness and persistence of tirzepatide treatment over 12 months in a real-world setting, particularly under individualized dosing. Prior studies have shown weight loss with tirzepatide, but real-world data on long-term outcomes and predictors of response are limited. Understanding these factors is crucial for clinicians considering tirzepatide for weight management in patients with obesity.
Methods
This was a multicenter, retrospective, observational study involving 249 adults with overweight or obesity treated with tirzepatide across 13 obesity practices in Greece. Treatment was self-funded, and dose escalation was individualized. The study evaluated treatment persistence, weight loss, metabolic outcomes, and predictors of response over 12 months.
Results
At 12 months, 170 out of 249 patients (68.3%) remained on treatment. Mean weight loss was reported as 19.9 ± 8.6%. The study also noted that 88.9%, 50.0%, and 27.2% of participants achieved ≥10%, ≥20%, and ≥25% weight loss, respectively. The mean dose of tirzepatide at 12 months was 9.71 mg.
Interpretation
The findings suggest that tirzepatide can lead to significant weight loss in a real-world setting, although the clinical significance of the weight loss should be interpreted cautiously. The study's retrospective design and the lack of a control group limit the ability to draw firm conclusions about the effectiveness of tirzepatide compared to other interventions. Additionally, the individualized dosing and self-funding aspects may not reflect broader clinical practice.
Key findings
- 68.3% remained on treatment at 12 months, n=249.
- Mean weight loss was 19.9 ± 8.6% at 12 months.
- 88.9%, 50.0%, and 27.2% achieved ≥10%, ≥20%, and ≥25% weight loss, respectively.
- Mean tirzepatide dose at 12 months was 9.71 mg.
- 70.4% experienced >2% additional weight loss during the second 6 months, n=179.
- Adjusted OR of 1.34 per additional percentage point of 6-month weight loss (P < 0.001).
Limitations
- retrospective observational study
- self-funded treatment may limit generalizability
- individualized dosing not protocol driven
- no control group for comparison
- long-term weight maintenance not established