Round 8 Open Questions

Answered this round

  • MASLD/NAFLD outcomes: ✓ SYNERGY-NASH Phase 2 (NEJM 2024) — up to 73% MASH resolution; SURPASS-3 MRI shows liver fat reduction in T2D; Phase 3 pending
  • SURPASS-5 detailed data: ✓ HbA1c −2.40% (10mg) and −2.34% (15mg) vs −0.86% placebo; 85–90% reached <7%; weight −6.2 to −10.9 kg vs +1.7 kg; key: reduce glargine 20% at initiation if HbA1c ≤8%

Still unanswered

  1. Tirzepatide in advanced CKD (eGFR <30): Safety and dosing in advanced CKD. SURPASS-4 enrolled CKD patients — what were the safety data for patients with eGFR <30? Is tirzepatide safe/dosed differently in this population?

  2. NHS patient feedback (UK, HealthUnlocked): UK-specific experience with Mounjaro on NHS — what do UK patients with T2D say about access, side effects, continuation criteria?

  3. Heart failure outcomes: Tirzepatide in T2D with heart failure — emerging evidence? SUMMIT trial results?

  4. Cost-effectiveness and real-world NHS uptake: Who is actually accessing tirzepatide under NICE TA924 in the UK? Any prescribing data? Access equity concerns?

  5. Thyroid carcinoma risk: The class warning (rodent MTC data) — what do human FAERS data and epidemiological studies show? Is this a real human risk?