Real-world effectiveness of tirzepatide among youth with type 2 diabetes and/or obesity: a multicenter analysis
Yllka Valdez, Natalie Segev, Neha Parimi, Manasi Vegesna, Elizabeth A. Brown, Stephanie Samuels, Michelle Van Name, Amy S. Shah, Risa M. WolfAbstract
Objectives
Tirzepatide has demonstrated efficacy for adults and youth with type 2 diabetes (T2D) and adults with obesity, but real-world pediatric data remain limited. We evaluated clinical outcomes among youth prescribed tirzepatide across three academic centers.
Methods
We conducted a multicenter retrospective study of patients aged ≤21 years with T2D and/or obesity who initiated tirzepatide and had at least one follow-up visit. Primary outcomes were changes in hemoglobin A 1c (A 1C ), body mass index (BMI), BMI z-score, and weight at first and second follow-up.
Results
The cohort included 74 patients. Median age was 18.4 years, 45.9 % were female, 86.5 % had T2D, and 78.4 % had prior GLP-1 RA exposure. At first follow-up (median 102 days [IQR 74, 133]), BMI decreased from 42.7 to 42.0 kg/m 2 (n=69; p=0.003), BMI z-score from 2.9 to 2.8 (n=69; p<0.001), weight from 126.2 to 123.9 kg (n=69; p=0.001). In those with T2D, A 1C decreased from 8.0 % to 7.2 % (n=58; p<0.001) and basal insulin dose declined from 59.7 to 43.9 units/day (n=24; p=0.008). At second follow-up, A 1C , BMI, BMI z-score, and weight remained significantly lower than baseline. In multivariable regression analysis among patients with T2D, prior GLP-1 RA use and partial nonadherence were associated with smaller A 1C reductions, while higher baseline A 1C and higher tirzepatide dose were associated with greater A 1C reductions.
Conclusions
In this multicenter real-world cohort, tirzepatide use among youth with T2D and/or obesity was associated with reductions in BMI and, in those with T2D, reductions in A 1C despite prior GLP-1 RA exposure.