Affiliations:
P.S. van den Hooff1,2, L. Bruyneel3, R. de Grooth3, M.T.E. Hopman1, J.H.M. Karregat1, V.M. Monpellier2,4
1Department of Medical Biosciences, Radboud University Medical Center, Nijmegen, The Netherlands;
2NOK Clinics, Huis Ter Heide, The Netherlands;
3Eli Lilly and Company, Indianapolis, Indiana, USA;
4Department of Endocrinology & Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Background
Tirzepatide demonstrated substantial weight loss in randomized controlled trials in individuals with overweight or obesity. This study describes real-world patient characteristics, observed percentage total weight loss (%TWL) and dosing patterns.
Methods
This retrospective study evaluated adults with overweight or obesity (without type 2 diabetes or prior obesity treatment) treated with tirzepatide and lifestyle coaching at outpatient clinics (NOK Clinics) in the Netherlands. Patient characteristics and weight were extracted from routine records. %TWL was calculated in patients with valid baseline and 6-month weights (total cohort) and in patients on ≥5 mg (lowest maintenance dose) at 6 months (dose subgroup). Dosing was assessed by chart review in patients giving additional consent.
Results
The total cohort comprised 563 patients. Six-month dosing was reviewed in 178 consenting patients: 38.8% had reached 10 mg and 6.2% 12.5 or 15 mg; 163 (91.6%) were on ≥5 mg (dose subgroup). Compared with the total cohort, these patients were older (median 53.8 vs 50.7 years) but otherwise similar at baseline (Table 1). Mean (SD) six-month %TWL was 16.7% (5.5) in the total cohort and 16.6% (5.4) in the dose subgroup. In the total cohort, 98.9%, 89.9%, 60.4% and 25.6% achieved ≥5%, ≥10%, ≥15% and ≥20% TWL, respectively.
Conclusion
In Dutch outpatient care, tirzepatide with lifestyle coaching, under real-world dosing patterns, was associated with clinically meaningful weight loss, generally consistent with clinical trials. Six-month doses reflected patient-centred titration generally within the approved label, rather than protocol-driven escalation.
Conflict of interest:
Funding: Eli Lilly and Company
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| Table 1. Baseline characteristics, presented as median [interquartile range], mean ± standard deviation; number (percentage); p-value represents comparison between groups1 | |||
| Parameter | Total cohort N = 563 |
Dose subgroup N = 163 |
p-value |
| Age (years) | 50.7 [39.6, 57.8] | 53.8 [46.5, 59.7] | <0.001 |
| Weight (kg) | 109.1 [97.7, 122.0] | 110.6 [100.3, 121.4] | 0.5 |
| Height (m) | 1.7 ± 0.1 | 1.7 ± 0.1 | 0.5 |
| Body Mass Index (kg/m²) | 36.1 [33.3, 40.3] | 36.4 [33.7, 40.4] | 0.6 |
| Fat-free mass (kg) | 57.0 [52.7, 61.3] | 56.1 [53.6, 61.3] | 0.8 |
| Missing data, n | 378 | 114 | |
| Fat percentage (%) | 42.6 ± 7.1 | 41.6 ± 7.4 | 0.3 |
| Missing data, n | 297 | 88 | |
| Sex, female | 409 (72.6%) | 114 (69.9%) | 0.5 |
| Hypertension | 86 (15.3%) | 33 (20.2%) | 0.13 |
| Osteoarthritis | 38 (6.7%) | 12 (7.4%) | 0.8 |
| Dyslipidemia | 31 (5.5%) | 11 (6.7%) | 0.5 |
| Obstructive Sleep apnea | 45 (8.0%) | 13 (8.0%) | >0.9 |
1 Wilcoxon rank sum test; Pearson’s Chi-squared test