Round 9 Open Questions
Answered this round
- Heart failure outcomes: ✓ SUMMIT trial (AHA 2024/NEJM): 46% reduction in worsening HF events in HFpEF+obesity; LV mass and adipose tissue reduced; CV death numerically higher (NS)
- Thyroid carcinoma human risk: ✓ FAERS and retrospective cohort data strongly reassuring — RR 0.348 (LOWER cancer incidence); boxed warning is rodent-based caution, not confirmed human risk
Still unanswered
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Tirzepatide in advanced CKD (eGFR <30): Safety and dosing — does tirzepatide require dose adjustment? What did SURPASS-4 data show for patients with low eGFR?
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NHS patient experience (UK, HealthUnlocked): UK-specific patient experience — do older T2D patients on NHS Mounjaro report different experiences vs US users? Access barriers, continuation criteria challenges?
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Obstructive sleep apnoea (OSA) outcomes: SURMOUNT-OSA trial — tirzepatide in obese patients with OSA. Relevant to T2D patients with OSA comorbidity.
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Comparative effectiveness vs semaglutide 2.4mg (Wegovy): SURMOUNT-5 head-to-head — tirzepatide vs semaglutide 2.4mg for weight loss in obesity. What about T2D specifically?
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Beta-cell function / diabetes remission: Does tirzepatide cause enough beta-cell preservation or recovery to achieve diabetes remission in some T2D patients? What does HbA1c <5.7% achievement rate in trials suggest?