Characteristics and Treatment Utilisation Patterns of Individuals Using Tirzepatide for Type 2 Diabetes in Germany

This study describes real-world characteristics and utilisation patterns of tirzepatide among adults with type 2 diabetes in German office-based practice. This retrospective observational study analysed data from the CompuGroup Medical Healthcare Database. Cohort 1 initiated tirzepatide between 1 December 2023 and 31 March 2024 and cohort 2 between 1 July and 30 September 2024. A subgroup of cohort 1 with ≥ 6 months’ follow-up data and uninterrupted tirzepatide use (cohort 1a) was also analysed. Descriptive statistics summarised baseline characteristics, prior therapy, and dosing patterns. Cohort 1 included 1223 individuals and cohort 2 included 2300; mean (± standard deviation) age was 59 ± 12 and 60 ± 12 years, respectively, and approximately 54% were male. Comorbidities, especially hypertension and dyslipidaemia, were frequent. Most individuals had prior insulin and/or glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment (cohort 1, 72.1%; cohort 2, 59.6%). A total of 458 individuals had 6 months’ follow-up (cohort 1a). The most common starting dose was 2.5 mg (71.2%). Use of higher doses gradually increased over time, with 5.0 mg becoming the most prevalent; at 6 months, 35.9% of individuals received 5.0 mg and 18.6% received 10.0 mg. This first comprehensive real-world study of tirzepatide use in Germany showed tirzepatide initiation primarily after GLP-1 RA and/or insulin therapy. Most individuals remained on 5.0 mg, with a notable proportion escalating to 10.0 mg. Cohort characteristics were generally similar to those in the SURPASS trials, supporting the relevance of trial findings to clinical practice. Little is known about how tirzepatide is used by physicians in clinical practice in Germany. This study used a large German database of electronic medical records to describe the characteristics of people with type 2 diabetes starting tirzepatide treatment, and treatment patterns, i.e. how tirzepatide is used, in everyday care. In total, 1223 people who started tirzepatide between December 2023 and March 2024 (cohort 1), and 2300 people who started tirzepatide between July and September 2024 (cohort 2) were included. The average age was around 60 years, and around half were men. High blood pressure and abnormal blood levels of lipids were common. Most people who were initiating tirzepatide had previously been treated with insulin and/or a glucagon-like peptide 1 receptor agonist. How tirzepatide was being prescribed was analysed in 458 people who used tirzepatide continuously for 6 months. Most people started treatment with a dose of 2.5 mg (71.2%). Use of higher doses gradually increased over time, with 5.0 mg becoming the most common; at 6 months, 35.9% of people received 5.0 mg and 18.6% received 10.0 mg. In this real-world evidence study, people with type 2 diabetes mostly started tirzepatide after glucagon-like peptide 1 receptor agonists and/or insulin, and the most common doses used were 5.0 and 10 mg.