OBJECTIVES: Tirzepatide is a once weekly glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist (RA) approved in the US for treatment of adults with type 2 diabetes (T2D) in May 2022 and obesity in November 2023. This study aimed to understand the real-world use of tirzepatide among people without T2D.

METHODS: This retrospective, observational, US claims-based study was conducted using the Merative Marketscan database. First observed claim of tirzepatide (National Drug Code for Mounjaro) during the index period (May 13, 2022–June 30, 2023) was the index date. Adults (≥18 years) without a T2D diagnosis during the 12-month pre-index period, and with continuous enrollment (12 months pre-index and 6 months post-index) were included. Baseline demographic and clinical characteristics during the pre-index period and treatment patterns in the post-index period were assessed using descriptive analyses.

RESULTS: A total of 7,150 people without T2D initiated tirzepatide during the index period. Mean (SD) age was 46.3 (9.7) years; majority were female (74.5%). Hypertension (36.2%), dyslipidemia (36.0%), and prediabetes (22.4%) were the most common comorbidities; 67.2% had ≥1 obesity-related comorbidity (ORC). Prior to initiating tirzepatide, in the pre-index period, 490 people (6.9%) had been prescribed previously approved anti-obesity medications (AOMs); of these, 303 (61.8%) had been prescribed semaglutide and 200 (40.8%) had been prescribed liraglutide. Additionally, 1,516 people (21.2%) had previously been prescribed metformin, while 1,016 (14.2%) had been prescribed non-AOM GLP-1 RAs. Of the 7,150 people initiating tirzepatide, 4,621 (64.6%) were persistent (treatment discontinuation was considered as >60 untreated days, based on days supply) on tirzepatide for ≥6 months.

CONCLUSIONS: This study provides insights into the real-world use of tirzepatide among US adults without T2D. The majority of patients had ≥1 ORC, 7% had been prescribed an AOM prior to tirzepatide initiation, and 65% were persistent on tirzepatide for ≥6 months.