Improved health-related quality of life with tirzepatide versus semaglutide in adults with obesity or overweight from the SURMOUNT-5 trial

Abstract

Aims: In SURMOUNT-5, tirzepatide led to greater body weight (BW) reduction versus semaglutide in adults with obesity without T2D. Health-related quality of life (HRQoL) with tirzepatide versus semaglutide in SURMOUNT-5 was evaluated.

Materials and methods: This analysis included on-treatment data from participants who received ≥1 dose of tirzepatide or semaglutide at their maximum tolerated dose. Changes in prespecified Short Form-36 Health Survey Version 2 (SF-36v2) norm-based scores for the Physical Component Summary (PCS), Mental Component Summary (MCS), and each domain, Patient Health Questionnaire-9, and Patient Global Impression of Status for Physical Activity scores were assessed at Week 72. Post hoc analysis of changes in SF-36v2 scores in participants with limited baseline physical function and by BW reduction thresholds was assessed at Week 72.

Results: Baseline scores were similar between treatments and among BW reduction categories. At Week 72, PCS scores improved from baseline with both treatments (p < 0.001). However, MCS scores did not show significant improvements from baseline (p > 0.05 for both treatment arms). All domain scores improved (p ≤ 0.008), with greater improvements in General Health (GH) with tirzepatide versus semaglutide (5.45 vs. 4.20; p = 0.003). Participants with limited physical function improved in PCS, Physical Functioning (PF), and GH with tirzepatide versus semaglutide (p ≤ 0.025). Higher BW reductions were associated with more improvement in PCS, PF, Role-Physical, Bodily Pain (BP), GH, and Vitality scores with tirzepatide and semaglutide (pooled).

Conclusions: HRQoL improved with tirzepatide and semaglutide, with greater improvement in GH with tirzepatide, especially in participants with limited baseline physical function. Participants who lost the most BW showed the greatest improvements in PF, BP, and GH.

Keywords: SF‐36v2; SURMOUNT‐5; health‐related quality of life; obesity; patient‐reported outcomes; semaglutide; tirzepatide.

FIGURE 1

Change from baseline in SF‐36v2 outcomes at Week 72 in SURMOUNT‐5. Data are LSM (SE) change from baseline in scores at Week 72 from the modified intent‐to‐treat population (efficacy analysis set). Estimated treatment differences (95% confidence intervals) are in brackets. *p < 0.05 and **p < 0.001 change from baseline; ^# p < 0.05 versus semaglutide. (A) Change from baseline in eight SF‐36v2 acute form domain scores (norm‐based) at Week 72. (B) Change from baseline in Physical Component Summary and Mental Component Summary scores at Week 72. LSM, least squares mean; MTD = maximum tolerated dose; SF‐36v2, Short Form‐36 Health Survey Version 2; SE, standard error.

FIGURE 2

Change from baseline in SF‐36v2 outcomes at Week 72 in participants with limited physical activity function at baseline in SURMOUNT‐5. Data are LSM (SE) change from baseline in scores at Week 72 from the modified intent‐to‐treat population (efficacy analysis set). Estimated treatment differences (95% confidence intervals) are in brackets. *p < 0.05 and **p < 0.001 change from baseline; ^# p < 0.05 versus semaglutide. Limited physical activity function was assessed at baseline by PGI‐S scores. (A) Change from baseline in eight SF‐36v2 acute form domain scores (norm‐based) at Week 72 in participants with limited physical activity function at baseline. (B) Change from baseline in Physical Component Summary and Mental Component Summary scores at Week 72 in participants with limited physical activity function at baseline. LSM, least squares mean; MTD, maximum tolerated dose; SF‐36v2, Short Form‐36 Health Survey Version 2; SE, standard error.

FIGURE 3

Change from baseline in SF‐36v2 outcomes at Week 72 by body weight reduction thresholds in SURMOUNT‐5. Data are mean (95% confidence interval) change from baseline in norm‐based scores at Week 72 from the modified intent‐to‐treat population (efficacy analysis set). Estimated treatment differences (95% confidence intervals) are in brackets. Data are from pooled tirzepatide and semaglutide groups (N = 750). (A) Change from baseline in physical functioning, role‐physical, bodily pain, and general health domain norm‐based scores at Week 72 by body weight reduction thresholds. (B) Change from baseline in vitality, social functioning, role‐emotional, and mental health domain norm‐based scores at Week 72 by body weight reduction thresholds. (C) Change from baseline in Physical Component Summary and Mental Component Summary scores at Week 72 by body weight reduction thresholds. SF‐36v2, Short Form‐36 Health Survey Version 2.