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Introduction <p>Tirzepatide has been associated with significant reductions in body weight in randomized clinical trials. However, real-world evidence evaluating the multisystemic effects of tirzepatide across the cardio-metabolic-kidney (CKM) continuum remains limited. The aim of this study was to assess the real-world persistence-driven cumulative benefits of tirzepatide beyond weight reduction in adults with obesity but without type 2 diabetes mellitus (T2DM).</p> Methods <p>This single-center observational cohort study evaluated in the United Arab Emirates adults with obesity (body mass index [BMI] ≥ 30&#xa0;kg/m<sup>2</sup>) treated with tirzepatide. Participants were stratified by treatment persistence: ≤ 1&#xa0;year (short-term) and &gt; 1&#xa0;year (long-term). Anthropometric, glycemic, lipid, hepatic, and renal outcomes were assessed at baseline and follow-up.</p> Results <p>One hundred participants (25 women; mean age 37.6 ± 10.0&#xa0;years; baseline BMI&#xa0;35.0&#xa0;[33.0–39.0]&#xa0;kg/m<sup>2</sup>) were included. Median weight reduction was − 8.1% in the short-term group and − 22.6% in the long-term group (<i>p</i> &lt; 0.001). 62% of long-term treated individuals achieved &gt; 15% weight loss versus 20% among short-term users. Significant between-group differences were observed in BMI (− 8.3% vs. − 19.1%), waist circumference (− 4.0% vs. − 9.2%), and glycated hemoglobin (HbA1c) (− 5.0% vs. − 7.2%). Total cholesterol decreased by − 10.1% vs. − 18.7% (<i>p</i> = 0.005), low-density lipoprotein cholesterol (LDL-C) by − 9.6% vs. − 30.5% (<i>p</i> &lt; 0.001), and triglycerides by − 11.2% vs. − 32.5% (<i>p</i> &lt; 0.001). Liver enzymes, aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) declined by − 11.3% and − 13.2%, respectively, in long term group with no significant improvement in short term group (between-groups<i> p</i> values for both liver enzymes &lt; 0.05). Serum creatinine declined significantly in the long-term group (− 6.6%, <i>p</i> &lt; 0.001), estimated glomerular filtration rate (eGFR) increasing by + 3.2% (<i>p</i> = 0.001), and blood urea nitrogen (BUN) decreasing by − 7.8% (<i>p</i> = 0.006) while microalbuminuria showed no meaningful changes. Weight loss correlated with improvements in LDL-C, triglycerides, and SGOT, and inversely with high-density lipoprotein cholesterol (HDL-C) changes.</p> Conclusions <p>Tirzepatide showed greater cumulative benefits across CKM syndrome outcomes during the second treatment year, highlighting the need to overcome adherence barriers in real-world settings.</p>

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Persistence-Dependent Effectiveness of Tirzepatide on the Cardio-Metabolic-Kidney Syndrome Outcomes in Obesity: Real-World Evidence from the United Arab Emirates

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月24日

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  • Imran Rashid Rangraze,
  • Mohamed El-Tanani,
  • Andrej Janez,
  • Viviana Maggio,
  • Syed Arman Rabbani,
  • Mojca Jensterle,
  • Ana Munda,
  • Elhadi Eltayeb Abbas,
  • Humam Sami Ali,
  • Mohammad Rashid Farooqi,
  • Mohamed Anas Faruk Patni,
  • Manfredi Rizzo

摘要

Introduction

Tirzepatide has been associated with significant reductions in body weight in randomized clinical trials. However, real-world evidence evaluating the multisystemic effects of tirzepatide across the cardio-metabolic-kidney (CKM) continuum remains limited. The aim of this study was to assess the real-world persistence-driven cumulative benefits of tirzepatide beyond weight reduction in adults with obesity but without type 2 diabetes mellitus (T2DM).

Methods

This single-center observational cohort study evaluated in the United Arab Emirates adults with obesity (body mass index [BMI] ≥ 30 kg/m2) treated with tirzepatide. Participants were stratified by treatment persistence: ≤ 1 year (short-term) and > 1 year (long-term). Anthropometric, glycemic, lipid, hepatic, and renal outcomes were assessed at baseline and follow-up.

Results

One hundred participants (25 women; mean age 37.6 ± 10.0 years; baseline BMI 35.0 [33.0–39.0] kg/m2) were included. Median weight reduction was − 8.1% in the short-term group and − 22.6% in the long-term group (p < 0.001). 62% of long-term treated individuals achieved > 15% weight loss versus 20% among short-term users. Significant between-group differences were observed in BMI (− 8.3% vs. − 19.1%), waist circumference (− 4.0% vs. − 9.2%), and glycated hemoglobin (HbA1c) (− 5.0% vs. − 7.2%). Total cholesterol decreased by − 10.1% vs. − 18.7% (p = 0.005), low-density lipoprotein cholesterol (LDL-C) by − 9.6% vs. − 30.5% (p < 0.001), and triglycerides by − 11.2% vs. − 32.5% (p < 0.001). Liver enzymes, aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) declined by − 11.3% and − 13.2%, respectively, in long term group with no significant improvement in short term group (between-groups p values for both liver enzymes < 0.05). Serum creatinine declined significantly in the long-term group (− 6.6%, p < 0.001), estimated glomerular filtration rate (eGFR) increasing by + 3.2% (p = 0.001), and blood urea nitrogen (BUN) decreasing by − 7.8% (p = 0.006) while microalbuminuria showed no meaningful changes. Weight loss correlated with improvements in LDL-C, triglycerides, and SGOT, and inversely with high-density lipoprotein cholesterol (HDL-C) changes.

Conclusions

Tirzepatide showed greater cumulative benefits across CKM syndrome outcomes during the second treatment year, highlighting the need to overcome adherence barriers in real-world settings.