12461 The Impact Of Switching From A Glp-1 Analog To Tirzepatide On Blood Glucose Levels, Body Weight, And Liver Function In Patients With Type 2 Diabetes

Abstract Disclosure: R. Mizoguchi: None. T. Sawamura: None. A. Ohmori: None. N. Yagishita: None. M. Kometani: None. T. Yoneda: None. S. Karashima: None. Context: Tirzepatide belongs to a new class of anti-diabetic agents that stimulate both glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors, which have strong blood glucose-lowering and large body weight reduction effect. Because of these characteristics of tirzepatide, it is expected to have beneficial effects for obese patients who need further blood glucose control. In the pharmacological approaches to glycemic treatment described by the American Diabetes Association, GLP-1 analogs are positioned as strong blood glucose-lowering agents that additionally reduce body weight (BW). Furthermore, GLP-1 analogs also improves liver injury in patients with fatty liver and diabetes. Tirzepatide reportedly has a greater blood glucose-lowering effect and body weight reduction than dulaglutide and semaglutide, which are common GLP-1 analogs in Japan. However, no data about the switching from these GLP-1 analogs to tirzepatide are available. In addition, The effect of tirzepatide on steatohepatitis is still unknown. Therefore, this study evaluated the effects of switching from dulaglutide to tirzepatide on blood glucose level, BW, and liver function. Material and Methods: Data from 40 patients with type 2 diabetes who received a prescription change from dulaglutide to tirzepatide were retrospectively analyzed at the 3 and 6 months after the switch. The analyzed data included glycosylated hemoglobin (HbA1c), BW, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase levels (γ-GTP) levels, and fibrosis-4 index. In addition, factors influencing the changes in HbA1c, BW, ALT, and fibrosis-4 index at 6 months were evaluated. Results: The mean HbA1c levels decreased from 7.9 ± 1.1% at baseline to 7.0 ± 0.8% at 3 months (p < 0.001) and 6.7 ± 0.7% at 6 months (p < 0.001). The mean BW decreased from 74.9 ± 18.3 kg at baseline to 71.9 ± 17.9 kg at 3 months (p < 0.001) and 71.3 ± 18.0 kg at 6 months (p < 0.001). The change in HbA1c level was negatively correlated with baseline HbA1c level. However, the BW reduction was observed regardless of baseline characteristics. AST, ALT, and γ-GTP levels were also significantly lower 6 months after the switch. The decrease in ALT level was greater in patients with higher baseline AST, ALT, and γ-GTP levels. The fibrosis-4 index did not improve during the study period, but there was a decreasing trend in patients with higher baseline fibrosis-4 index. Conclusion: Switching from dulaglutide to tirzepatide may have beneficial effects on blood glucose levels, BW, and liver function in patients with type 2 diabetes. Presentation: 6/2/2024