Round 7 Open Questions
Answered this round
- Advanced T2D on basal-bolus insulin: ✓ SURPASS-5/6 provide basal insulin context; reduce basal 20% on initiation if HbA1c <8%; no specific data for TDD >80U full basal-bolus — remains evidence gap
- ADA/EASD 2022 Consensus: ✓ Tirzepatide specifically named; GLP-1 RA prioritised for T2D+CVD; SGLT2i for HF/CKD; weight management as core goal
Still unanswered
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MASLD/NAFLD outcomes: SURPASS-3 MRI substudy shows liver fat reduction. Any dedicated hepatic outcomes data? Tirzepatide in NASH/MASLD trials? SYNERGY-NASH?
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Tirzepatide in eGFR <30: Safety and dosing in advanced CKD. Does tirzepatide require dose adjustment below eGFR 30?
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NHS patient experience (HealthUnlocked, UK forums): UK-specific experience — what do patients say about Mounjaro on NHS? Cost barrier removed, older T2D patients; any reports about continuation criteria being challenging?
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SURPASS-5 detailed numbers: Full efficacy data from SURPASS-5 (tirzepatide add-on to basal insulin glargine vs placebo) — HbA1c and weight specifics for each dose; confirm 40-week results.
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Cost-effectiveness and access inequities: In the UK (NICE TA924), who is actually accessing Mounjaro? GP vs specialist? Any NHS prescribing data? Real-world uptake.