Tirzepatide—a first-in-class GIP/GLP-1 receptor agonist (‘twincretin’)—is a single molecule that acts as an agonist at both GLP-1 and GIP receptors.

Tirzepatide demonstrated substantial clinical benefits across a range of metabolic outcomes in a broad patient population and when compared with a range of therapies currently considered best practice in T2D management.

A total of 43–62% of participants receiving tirzepatide 15 mg in the SURPASS clinical trials—even those with long-standing T2D—achieved normoglycaemia (HbA1c < 5.7%), and 39–51% achieved normoglycaemia together with clinically significant weight loss (≥ 5%) without hypoglycaemia. This challenges existing treatment paradigms and targets, which may need to be revised.

Determining the future potential for tirzepatide in cardio-renal-metabolic disease will depend on the outcomes of dedicated cardiovascular outcomes and kidney trials, but tirzepatide may offer additional benefits beyond glycaemic control for individuals at high risk for or with established cardio-renal-metabolic disease.