A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight for the Maintenance of Weight Loss (SURMOUNT-4)
Efficacy and Safety of Tirzepatide Once Weekly Versus Placebo for Maintenance of Weight Loss in Participants Without Type 2 Diabetes Who Have Obesity or Are Overweight With Weight-Related Comorbidities: A Randomized, Double-Blind, Placebo-Controlled Trial (SURMOUNT-4)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Buenos Aires, Argentina, C1419AHN
- Asociación de Beneficencia Hospital Sirio Libanés
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Buenos Aires
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Caba, Buenos Aires, Argentina, C1120AAC
- Centro Medico Viamonte
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Caba, Buenos Aires, Argentina, C1060ABN
- CEDIC
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Ciudad Autónoma de Buenos Aire, Buenos Aires, Argentina, C1023AAB
- STAT Research S.A.
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Ciudad Autónoma De Buenos Aire
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Buenos Aires, Ciudad Autónoma De Buenos Aire, Argentina, C1128AAF
- Mautalen Salud e Investigación
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Ciudad Autonoma de Buenos Aire, Ciudad Autónoma De Buenos Aire, Argentina, C1425AGC
- Centro Medico Dr Laura Maffei Investigacion Clinica Aplicada
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Santa Fe
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Rosario, Santa Fe, Argentina, 2000
- Instituto Médico Catamarca IMEC
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Rio de Janeiro, Brazil, 22241-180
- IBPClin - Instituto Brasil de Pesquisa Clínica
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São Paulo, Brazil, 01228-000
- CPQuali Pesquisa Clínica
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Espírito Santo
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Vitória, Espírito Santo, Brazil, 29055450
- CEDOES
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Paraná
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Curitiba, Paraná, Brazil, 80030-480
- Cline Research Center
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Rio Grande Do Sul
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Porto Alegre, Rio Grande Do Sul, Brazil, 90430-001
- Nucleo de Pesquisa Clínica do Rio Grande do Sul
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São Paulo
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Campinas, São Paulo, Brazil, 13034-685
- Centro de Pesquisa São Lucas
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Sao Paulo, São Paulo, Brazil, 03325-050
- BR Trials - Ensaios Clinicos e Consultoria
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São José dos Campos, São Paulo, Brazil, 12243-280
- ISPEM - Instituto São Jose dos Campos em Pesquisas Medicas
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Bayamon, Puerto Rico, 00959
- Centro de Endocrinologia Alcantara Gonzalez
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San Juan, Puerto Rico, 00921
- Private Practice Dr. Martha Gomez Cuellar
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Vega Baja, Puerto Rico, 00694
- Wellness clinical Research Vega Baja
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Taichung, Taiwan, 40447
- China Medical University Hospital
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Taichung, Taiwan, 402
- Chung Shan Medical University Hospital
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Tainan, Taiwan, 704
- National Cheng-Kung Uni. Hosp.
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Taipei, Taiwan, 10002
- National Taiwan University Hospital
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Alabama
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Pelham, Alabama, United States, 35124
- Cahaba Research
-
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California
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La Jolla, California, United States, 92037
- Scripps Memorial Hospital La Jolla
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Los Angeles, California, United States, 90057
- National Research Institute - Wilshire
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Panorama City, California, United States, 91402
- National Research Institute
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San Diego, California, United States, 92103
- Artemis Institute for Clinical Research
-
Tustin, California, United States, 92780
- University Clinical Investigators, Inc.
-
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Colorado
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Golden, Colorado, United States, 80401
- New West Physicians Clinical Research
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Monument, Colorado, United States, 80132
- Optumcare Colorado Springs - Monument
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Florida
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Jacksonville, Florida, United States, 32277
- Care Partners Clinical Research
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Margate, Florida, United States, 33063
- South Florida Clinical Research Institute
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Ocala, Florida, United States, 34470
- Renstar Medical Research
-
Tampa, Florida, United States, 33613
- ForCare Clinical Research
-
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Georgia
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Roswell, Georgia, United States, 30076
- Endocrine Research Solutions, Inc.
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Union City, Georgia, United States, 30291
- SKY Clinical Research Network Group-Blake
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Hawaii
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Honolulu, Hawaii, United States, 96814
- East-West Medical Research Institute
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Idaho
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Idaho Falls, Idaho, United States, 83404
- Rocky Mountain Clinical Research
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Illinois
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Flossmoor, Illinois, United States, 60422
- Healthcare Research Network - Chicago
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Gurnee, Illinois, United States, 60031
- Clinical Investigation Specialists
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Indiana
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Indianapolis, Indiana, United States, 46260
- Midwest Institute for Clinical Research
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New Albany, Indiana, United States, 47150
- American Health Network of Indiana, LLC - New Albany
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Kansas
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Topeka, Kansas, United States, 66606
- Cotton O'Neil Clinic
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Kentucky
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Louisville, Kentucky, United States, 40213
- L-MARC Research Center
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Maryland
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Elkridge, Maryland, United States, 21075
- Centennial Medical Group
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Hyattsville, Maryland, United States, 20782
- MedStar Health Research Institute (MedStar Physician Based Research Network)
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Massachusetts
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Methuen, Massachusetts, United States, 01844
- ActivMed Practices and Research
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Michigan
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Troy, Michigan, United States, 48098
- Arcturus Healthcare , PLC, Troy Internal Medicine Research Division
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Missouri
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Saint Peters, Missouri, United States, 63303
- StudyMetrix Research
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Montana
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Kalispell, Montana, United States, 59901
- Glacier View Research Institute - Endocrinology
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New York
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New York, New York, United States, 10065
- Weill Cornell Medical College
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North Carolina
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Chapel Hill, North Carolina, United States, 27514
- University of North Carolina Medical Center
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Greensboro, North Carolina, United States, 27408
- PharmQuest
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Winston-Salem, North Carolina, United States, 27157
- Wake Forest University Baptist Medical Center (WFUBMC)
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North Dakota
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Fargo, North Dakota, United States, 58104
- Lillestol Research
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Ohio
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Columbus, Ohio, United States, 43213
- Aventiv Research Inc
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Oklahoma
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Norman, Oklahoma, United States, 73069
- Intend Research, LLC
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Oregon
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Portland, Oregon, United States, 97210
- Summit Research Network
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Pennsylvania
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Camp Hill, Pennsylvania, United States, 17011
- Capital Area Research, LLC
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South Carolina
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Greenville, South Carolina, United States, 29607
- Tribe Clinical Research, LLC
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Texas
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Bellaire, Texas, United States, 77401
- The University of Texas Health Science Center at Houston
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Dallas, Texas, United States, 75230
- Dallas Diabetes Research Center
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Dallas, Texas, United States, 75231
- North Texas Endocrine Center
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Houston, Texas, United States, 77043
- Biopharma Informatic, LLC
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North Richland Hills, Texas, United States, 76180
- North Hills Family Medicine/North Hills Medical Research
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San Antonio, Texas, United States, 78229
- Clinical Trials of Texas, Inc.
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Tomball, Texas, United States, 77375
- Northwest Houston Heart Center
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Virginia
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Newport News, Virginia, United States, 23606
- Health Research of Hampton Roads, Inc.
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Washington
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Olympia, Washington, United States, 98502
- Capital Clinical Research Center
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Renton, Washington, United States, 98057
- Rainier Clinical Research Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Body Mass Index (BMI) ≥30 kilograms per square meter (kg/m²), or ≥27 kg/m² and previous diagnosis with at least one of the following comorbidities: hypertension, dyslipidemia, obstructive sleep apnea, cardiovascular disease
- History of at least one unsuccessful dietary effort to lose body weight
Exclusion Criteria:
- Diabetes mellitus
- Change in body weight greater than 5 kg within 3 months prior to starting study
- Obesity induced by other endocrinologic disorders or monogenetic or syndromic forms of obesity
- History of pancreatitis
- Family or personal history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN-2)
- History of significant active or unstable major depressive disorder (MDD) or other severe psychiatric disorder within the last 2 years
- Any lifetime history of a suicide attempt
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Tirzepatide (lead-in)
Participants received weekly doses of tirzepatide subcutaneously (SC) for 36 weeks, starting at 2.5 milligrams (mg) and increasing by 2.5 mg every 4 weeks, as tolerated, up to the maximum tolerated dose (MTD) of either 10 mg or 15 mg.
|
Administered SC
Other Names:
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Experimental: Tirzepatide MTD
Participants continued tirzepatide MTD (either 10 mg or 15 mg) for an additional 52 weeks.
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Administered SC
Other Names:
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Placebo Comparator: Placebo
Participants received weekly doses of placebo SC for 52 weeks.
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Administered SC
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percent Change From Randomization in Body Weight at Week 88
Time Frame: Randomization (Week 36), Week 88
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Least square (LS) mean was analysed by mixed model repeated measures (MMRM) model with randomization + analysis country + sex + interactive web response system (IWRS) MTD at Week 36 + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Randomization (Week 36), Week 88
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent Change From Randomization in Body Weight at Week 64
Time Frame: Randomization (Week 36), Week 64
|
LS mean was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Randomization (Week 36), Week 64
|
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Change From Randomization in Body Weight
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + treatment + time + treatment*time (Type III sum of squares) as variables.
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Randomization (Week 36), Week 88
|
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Change From Randomization in Waist Circumference
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
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Randomization (Week 36), Week 88
|
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Change From Randomization in Body Mass Index (BMI)
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + treatment + time + treatment*time (Type III sum of squares) as variables.
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Randomization (Week 36), Week 88
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Change From Randomization in Fasting Glucose
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Randomization (Week 36), Week 88
|
|
Change From Randomization in Hemoglobin A1c (HbA1c)
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Randomization (Week 36), Week 88
|
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Percent Change From Randomization in Fasting Insulin
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with log(actual measurement/randomization) = log (randomization) + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
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Randomization (Week 36), Week 88
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Percent Change From Randomization in Lipid Parameters (Total Cholesterol, Low Density Lipoprotein (LDL) Cholesterol, High Density Lipoprotein (HDL) Cholesterol, Very Low Density Lipoprotein (VLDL) Cholesterol, Triglycerides, Free Fatty Acids (FFA))
Time Frame: Randomization (Week 36), Week 88
|
LS mean was analysed by MMRM model with log(actual measurement/randomization) = log (randomization) + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Randomization (Week 36), Week 88
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Change From Randomization in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP)
Time Frame: Randomization (Week 36), Week 88
|
LS mean change was analysed by MMRM model with randomization + analysis country + sex + IWRS MTD at Week 36 + Weight Loss at Week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
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Randomization (Week 36), Week 88
|
|
Change From Randomization in Short Form 36 Version 2 Health Survey (SF 36v2) Acute Form - Physical Functioning Domain Score
Time Frame: Randomization (Week 36), Week 88
|
The SF-36v2 acute form assesses health-related quality of life (HRQoL) on 8 domains: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health. The Physical-Functioning domain assesses limitations due to health "now" and consists of 10-items, each rated on a 3-point Likert scale. Scoring of the domain is norm-based and presented in the form of T-scores, with a mean of 50 and standard deviation of 10; higher scores indicate better levels of function. Range cannot be specified in norm-based scores. LS mean was analysed by analysis of covariance (ANCOVA) model with randomization + analysis Country + sex + weight loss at Week 36 (< 10%, >= 10%) + IWRS MTD at Week 36 + treatment (type III sum of squares) as variables. |
Randomization (Week 36), Week 88
|
|
Change From Randomization in Impact of Weight on Quality of Life Lite Clinical Trials Version (IWQOL-Lite-CT) - Physical Function Composite Score
Time Frame: Randomization (Week 36), Week 88
|
The IWQOL Lite-CT consists of 20 items, assessing 2 primary domains of obesity related HRQoL: Physical (7 items) and Psychosocial (13 items). A 5-item subset of the Physical domain - the Physical Function composite - is also supported. Items in the Physical Function composite describe physical impacts related to general and specific physical activities. All items in the physical domain are rated on either a 5-point frequency ("never" to "always") scale or a 5-point truth ("not at all true" to "completely true") scale. Total score of IWQOL-Lite-CT composite ranges from 0 to 100, with higher scores reflecting better health-related quality of life. LS mean was analysed by ANCOVA model with randomization + analysis Country + sex + weight loss at Week 36 (< 10%, >= 10%) + IWRS MTD at Week 36 + treatment (type III sum of squares) as variables. |
Randomization (Week 36), Week 88
|
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Percentage of Participants Who Maintain at Least 80% of the Body Weight Lost During the Open-Label Lead-In Period
Time Frame: Week 88
|
Percentage of Participants Who Maintain at least 80% of the Body Weight Lost During the Open-Label Lead-In Period was analysed by Logistic regression model with missing value imputed by MMRM at week 88.
Missing values were imputed by predictions using observed data in the efficacy analysis set from the same treatment group through an MMRM analysis model for post-baseline measures with Baseline + Analysis Country + Sex + IWRS MTD at Week 36 + randomization + Treatment + Time + Treatment*Time as variables.
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Week 88
|
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Percentage of Participants Who Achieve ≥5%, ≥10%, ≥15%, ≥20% Body Weight Reduction From Baseline
Time Frame: Baseline (Week 0) to Week 88
|
Percentage of Participants Who Achieve ≥5%, ≥10%, ≥15%, ≥20% Body Weight Reduction from baseline was analysed by Logistic regression model with missing value imputed by MMRM at week 88.
Missing values were imputed by predictions using observed data in the efficacy analysis set from the same treatment group through an MMRM analysis model for post-baseline measures with Baseline + Analysis Country + Sex + IWRS MTD at Week 36 + randomization + Treatment + Time + Treatment*Time as variables.
|
Baseline (Week 0) to Week 88
|
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Time to First Occurrence of Participants Returning to >95% Baseline Weight for Those Who Lost ≥5% During the Open-Label Lead-In Period
Time Frame: Randomization (Week 36) to Week 88
|
Time to first occurrence of participants returning to >95% baseline weight for those who lost ≥5% during the open-label lead-in period.
|
Randomization (Week 36) to Week 88
|
|
Change From Baseline in BMI
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + BMI at randomization (kg/m^2) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Change From Baseline in Body Weight
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + body weight at randomization (kg) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Percent Change From Baseline in Body Weight
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + body weight at randomization (kg) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Change From Baseline in Waist Circumference
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Change From Baseline in Fasting Glucose
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Change From Baseline in HbA1c
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Percent Change From Baseline in Fasting Insulin
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with log(actual measurement/baseline) = log (baseline) + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Percent Change From Baseline in Lipid Parameters (Total Cholesterol, LDL Cholesterol, HDL Cholesterol, VLDL Cholesterol, Triglycerides, FFAs)
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with log(actual measurement/baseline) = log (baseline) + analysis country + sex + IWRS MTD at Week 36 + weight loss at week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Change From Baseline in SBP, DBP
Time Frame: Baseline (Week 0), Week 88
|
LS mean was analysed by MMRM model with baseline + analysis country + sex + IWRS MTD at Week 36 + Weight Loss at Week 36 (< 10%, >= 10%) + treatment + time + treatment*time (Type III sum of squares) as variables.
|
Baseline (Week 0), Week 88
|
|
Change From Baseline in SF 36v2 Acute Form - Physical Functioning Domain Score
Time Frame: Baseline (Week 0), Week 88
|
The SF-36v2 acute form assesses health-related quality of life (HRQoL) on 8 domains: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health. The Physical-Functioning domain assesses limitations due to health "now" and consists of 10-items, each rated on a 3-point Likert scale. Scoring of the domain is norm-based and presented in the form of T-scores, with a mean of 50 and standard deviation of 10; higher scores indicate better levels of function. Range cannot be specified in norm-based scores. LS mean was analysed by analysis of covariance (ANCOVA) model with randomization + analysis Country + sex + weight loss at Week 36 (< 10%, >= 10%) + IWRS MTD at Week 36 + treatment (type III sum of squares) as variables. |
Baseline (Week 0), Week 88
|
|
Change From Baseline in IWQOL-Lite-CT - Physical Function Composite Score
Time Frame: Baseline (Week 0), Week 88
|
The IWQOL Lite-CT consists of 20 items, assessing 2 primary domains of obesity related HRQoL: Physical (7 items) and Psychosocial (13 items). A 5-item subset of the Physical domain - the Physical Function composite - is also supported. Items in the Physical Function composite describe physical impacts related to general and specific physical activities. All items in the physical domain are rated on either a 5-point frequency ("never" to "always") scale or a 5-point truth ("not at all true" to "completely true") scale. Total score of IWQOL-Lite-CT composite ranges from 0 to 100, with higher scores reflecting better health-related quality of life. LS mean was analysed by ANCOVA model with baseline + analysis Country + sex + weight loss at Week 36 (< 10%, >= 10%) + IWRS MTD at Week 36 + treatment (type III sum of squares) as variables. |
Baseline (Week 0), Week 88
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Eli Lilly and Company
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 17247
- I8F-MC-GPHN (Other Identifier: Eli Lilly and Company)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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