An estimated 180,000 people could benefit from a decision by NICE to recommend a new treatment option for adults with difficult-to-manage type 2 diabetes, alongside diet and exercise.
Tirzepatide, also known as Mounjaro, is a dual receptor agonist that acts on both glucose-dependent insulinotropic polypeptide (GIP) receptors and glucagon-like peptide-1 (GLP-1) receptors. It is administered as a once-weekly injection.
Clinical trials indicate that tirzepatide use results in significant reductions in blood glucose levels and body weight compared with semaglutide, insulin therapy or placebo. Trial evidence included 81% to 97% of participants achieving better glycaemic control, and 54% to 88% reaching a 5% or greater reduction in body weight.
Under the recommendations, previous triple therapy with metformin and two other antidiabetes drugs must have been ineffective, not tolerated or contraindicated. Tirzepatide is only recommended in people with a BMI ≥35 kg/m2 and specific psychological or other medical problems associated with obesity; or who have a BMI <35 kg/m2 but for whom insulin therapy would have significant occupational implications or weight loss would benefit other significant obesity-related complications.
This comes after the manufacturer provided additional analyses and modelling to the NICE committee on the drug’s clinical and cost-effectiveness. Previous draft guidance had rejected the use of tirzepatide as an alternative to other antidiabetes drugs.
While news of this potential new treatment option for people with type 2 diabetes has been welcomed, many will hope that tirzepatide will not be hit by the same problems that currently afflict supplies of GLP-1 RA medication.
NICE is expected to publish its final guidance on 11 October 2023, following which it is hoped that the product will be made available in the NHS within 90 days.
The draft NICE recommendations can be read here.
