Effects of Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide on Biomarkers of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes

Mark L Hartman, Arun J Sanyal, Rohit Loomba, Jonathan M Wilson, Amir Nikooienejad, Ross Bray, Chrisanthi A Karanikas, Kevin L Duffin, Deborah A Robins, Axel Haupt, Mark L Hartman, Arun J Sanyal, Rohit Loomba, Jonathan M Wilson, Amir Nikooienejad, Ross Bray, Chrisanthi A Karanikas, Kevin L Duffin, Deborah A Robins, Axel Haupt

Abstract

Objective: To determine the effect of tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 receptors, on biomarkers of nonalcoholic steatohepatitis (NASH) and fibrosis in patients with type 2 diabetes mellitus (T2DM).

Research design and methods: Patients with T2DM received either once weekly tirzepatide (1, 5, 10, or 15 mg), dulaglutide (1.5 mg), or placebo for 26 weeks. Changes from baseline in alanine aminotransferase (ALT), aspartate aminotransferase (AST), keratin-18 (K-18), procollagen III (Pro-C3), and adiponectin were analyzed in a modified intention-to-treat population.

Results: Significant (P < 0.05) reductions from baseline in ALT (all groups), AST (all groups except tirzepatide 10 mg), K-18 (tirzepatide 5, 10, 15 mg), and Pro-C3 (tirzepatide 15 mg) were observed at 26 weeks. Decreases with tirzepatide were significant compared with placebo for K-18 (10 mg) and Pro-C3 (15 mg) and with dulaglutide for ALT (10, 15 mg). Adiponectin significantly increased from baseline with tirzepatide compared with placebo (10, 15 mg).

Conclusions: In post hoc analyses, higher tirzepatide doses significantly decreased NASH-related biomarkers and increased adiponectin in patients with T2DM.

Trial registration: ClinicalTrials.gov NCT03131687.

Conflict of interest statement

This article is featured in a podcast available at https://www.diabetesjournals.org/content/diabetes-core-update-podcasts.

© 2020 by the American Diabetes Association.

Figures

Figure 1
Figure 1
Change from baseline in NASH-related biomarkers ALT (A), AST (B), K-18 (C), Pro-C3 (D), and adiponectin (E) through 26 weeks in patients with T2DM. Data are LSM (SE). Modified intention-to-treat population excludes data after study drug discontinuation or use of glucose-lowering rescue medication. *P < 0.05 change from baseline; #P < 0.05 vs. placebo; ‡P < 0.05 vs. dulaglutide.

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