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[SURPASS CVOT:在2型糖尿病中使用蒂尔泽帕提德与杜拉格卢提德对心血管的益处]
André Scheen1,2, Patrizio Lancellotti3,4
1Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Liège, Belgique.
Revue medicale de Liege
|March 12, 2026
概括
双重GIP/GLP-1受体激动剂蒂尔泽帕提德在2型糖尿病患者中与杜拉格卢提德相比,在减少主要心血管不良事件 (MACE) 方面达到了非劣势. 虽然不是优越的,但蒂尔泽帕提德显示了降低全因死亡率的趋势.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 类似葡萄糖-1受体激动剂 (GLP-1RAs) 有效地减少2型糖尿病 (T2D) 患者的主要不良心血管事件 (MACEs).
- 蒂尔泽帕提德是一种双重依赖葡萄糖的胰岛素型多 (GIP) /GLP-1受体激动剂,在SURPASS计划中,与选择性GLP-1RA相比,它显示出优越的血糖和体重控制.
- 在REWIND试验中,选择性GLP-RADulaglutide已经证明了与安慰剂相比,MACE的显著减少.
研究的目的:
- 为了证明蒂尔泽帕提德与杜拉格卢提德相比在降低T2D患者和已确定的动脉样性心血管疾病患者的MACE的非劣势.
- 在这个高风险人群中评估蒂尔泽帕提德与杜拉格卢提德的安全性和有效性.
主要方法:
- 在SURPASS CVOT试验中,使用了活性比较剂 (dulaglutide) 而不是安慰剂.
- 主要终点是MACEs (心血管死亡,非致命心肌梗塞或非致命中风的组合) 的减少.
- 随访时间中位数为四年.
主要成果:
- 在MACE降低方面,蒂尔泽帕提德与杜拉格卢提德的非劣势得到了实现 (p = 0.003).
- 蒂尔泽帕提德在主要终点 (危险比率[HR]0.92;95%信心区间[CI]0.83至1.01;P=0.09) 上没有表现出优于杜拉格卢提德的优势.
- 一项探索性分析显示,提尔泽帕提德在降低全因死亡率方面的趋势有利于提尔泽帕提德 (HR 0.84;95% CI 0.75至0.94).
结论:
- 在SURPASS CVOT证实了tirzepatide在T2D和动脉样硬化心血管疾病患者的疗效和安全性,与活性GLP-1RA比较剂相比.
- 虽然在MACE降低方面不低于杜拉格卢提德,但提泽帕提德需要进一步研究降低全因死亡率的潜在益处.
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