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ForumsTirzepatide (Mounjaro / Zepbound)SURPASS 1-5 program: tirzepatide T2DM efficacy data compilation — need advice Page 3

SURPASS 1-5 program: tirzepatide T2DM efficacy data compilation — need advice

PharmacoVig_BOS Mon, Jun 23, 2025 at 7:05 PM 15 replies 1,430 viewsPage 3 of 3
ChrisMacros
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Jun 24, 2025 at 9:57 AM#11
Dr.MetabolicMD said:
Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

Genuinely useful, thank you. I had the facts and not the framework. Taking it to my next appointment.

41 16RunnerRach, TrialNerd_Beth, HPLC_Greg and 38 others
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Dr.NutriCornell
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Ithaca, NY
Jun 24, 2025 at 4:08 PM#12

From the other side of the consultation, briefly.

Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows:

Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill coefficient ≈ 1.3
Tirzepatide: ED50 ≈ 6mg, Emax ≈ -25%, Hill coefficient ≈ 1.5

Clinical implication: most patients achieve >80% of maximal response by the mid-range dose (1.7mg sema, 10mg tirz). Going to the maximum dose provides diminishing returns — possibly not worth the additional side effect burden for some patients. Individualize dosing based on response vs tolerability.

Last edited: Jun 24, 2025 at 6:08 PM
40 15Dr.SleepRoch, laura_annarbor, JenMemphis and 37 others
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COA_Karl
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Pennsylvania
Jun 24, 2025 at 10:19 PM#13
Dr.KarenChen said:
HbA1c reflects roughly three months of average glycaemia weighted toward the most recent weeks, which is why repeating it at six weeks tells you very…

This is where I part company with the consensus forming above. I would resist the confidence. Half of what this board was certain about two years ago has since been quietly dropped, and nobody went back to correct the threads.

39 14hyun_seoul, jim_asheville, matt_MKE and 36 others
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dan_philly
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Philadelphia, PA
Jun 25, 2025 at 4:30 AM#14

Adding the numbers, since they settle part of this. Give anything pharmacological four weeks before you judge it, and give anything measured weekly a four-point rolling average before you call it a trend.

Correct me if the detail matters more than I have assumed.

Last edited: Jun 25, 2025 at 7:30 AM
38 13Dr.CardioMD, EndoResFellow, PharmacoVig_BOS and 35 others
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Admin
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Jun 25, 2025 at 10:41 AM#15

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Thread quality here is what the rules are for. Keep it up.

37 12PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 34 others
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