Round 16 Open Questions
Researched this round
- Long-term T2D outcomes: SURPASS-4 104-week post-hoc (HbA1c sustained) — note created
- Drug interactions: warfarin case report + FDA label + levothyroxine signal — note created
- Frail/≥75 subgroup: confirmed absent — Older Adults T2D note updated
- CV superiority vs placebo: confirmed structural gap — Cardiovascular Risk note updated
Still unanswered
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Formal levothyroxine PK interaction study: Has Eli Lilly or any academic group published a pharmacokinetic study of tirzepatide + levothyroxine co-administration? The patient-reported signal is consistent but lacks mechanistic quantification.
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SURMOUNT-MMO interim data: Any published interim results from SURMOUNT-MMO (NCT05556512) as obesity+CVD outcomes trial approaches 2027 completion? Would be the first tirzepatide-vs-placebo MACE signal.
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Beta-cell function at 2+ years: SURPASS-4 104-week post-hoc did not report HOMA2-B data. Is beta-cell function preservation (vs accelerated decline in T2D natural history) maintained at 2 years? Critical for understanding whether tirzepatide slows disease progression or merely compensates.
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Drug holiday / dose reduction protocols: No clinical trial has evaluated planned dose reduction (e.g., stepping from 15mg to 10mg after 12 months of good control) in T2D — is glycaemic control maintained? This is a real-world access and cost question.