Real‐world use and effectiveness of tirzepatide among individuals without type 2 diabetes: Results from the Optum Market Clarity database

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Aims To understand real‐world tirzepatide utilization and effectiveness (change in weight and body mass index [BMI]) among people without type 2 diabetes (T2D) in the United States. Materials and Methods This retrospective, observational study used Optum's de‐identified Market Clarity database (index date: first‐observed tirzepatide claim; index period: 13 May 2022–30 September 2023). Outcomes were assessed in 3 cohorts: (1) Overall cohort: age ≥18 years; ≥1 tirzepatide claim; no baseline T2D diagnosis codes, anti‐diabetes medication use (except metformin) or glycated haemoglobin ≥6.5%; continuous medical and pharmacy enrolment for ≥12 months pre‐index. (2) Utilization cohort: all above criteria and anti‐obesity medication (AOM)‐eligible individuals (BMI ≥30 kg/m 2 , or ≥27 kg/m 2 with ≥1 obesity‐related complication [ORC]) for assessment of tirzepatide utilization (persistence, discontinuation, dose escalation and switching 6 months post‐index). (3) Effectiveness cohort: all above criteria and AOM‐eligible glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA)‐naive individuals persistent on tirzepatide for ≥6 months with pre‐ and post‐index weight and BMI measurements for assessment of tirzepatide effectiveness (mean absolute and percent bodyweight/BMI change from baseline and bodyweight/BMI reduction ≥5%, ≥10%, ≥15% and ≥20%). All analyses were descriptive. Results Overall cohort included 20,998 individuals (mean age: 47.4 years, female: 74.9%, mean BMI: 36.9 kg/m 2 ). At index, 66.0% of individuals had ≥1 ORC, while 44.4% had ≥2 ORCs. Persistence in the utilization cohort was 55.4%; 30.8% switched to a different AOM/GLP‐1 RA analogue or restarted tirzepatide after discontinuation, and by the sixth prescription fill, 74.2% were on <10 mg tirzepatide. Mean weight reduction in the effectiveness cohort was 11.9% at 6 months post‐index (≥5%: 85.8%; ≥10%: 61.5%). Conclusions Real‐world evidence suggests multimorbidity is common among tirzepatide initiators. While tirzepatide dose escalation was slower than in clinical trials, individuals achieved weight reduction at 6 months, consistent with clinical trials.