Posts Tagged ‘Mounjaro’

If you are a diabetic patient, there may be a new and exciting treatment option for your care. In May, the Food and Drug Administration (FDA) approved a new medication called Mounjaro (tirzepatide) for the treatment of Type II Diabetes in addition to diet and exercise for patients over the age of 18.

This medication is the first of its kind as it combines two different medication classes in a single injection. One class is known as glucagon-like peptide-1 (GLP-1) which you may be familiar with as medications such as Trulicity and Ozempic fall into this category.

The second component of Mounjaro is known as glucose-dependent insulinotropic polypeptide, or GIP for short. This combination is what makes Mounjaro so special and the first of its kind.

Below is a list of the ways that each of these medication classes work in your body to help lower blood sugar and A1c:

Mounjaro is a once weekly injection just like most other GLP-1’s and is available in doses of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg weekly. The medication is supplied in a box containing four prefilled, auto-injecting pens (shown below). The pens are single use and should be disposed of after use.

Since the injections are once weekly, one box of four pens is a 28 day or one month supply. Like both Trulicity and Ozempic, patients must start on the lowest dose and may increase to the next dose after at least four weeks of treatment if needed. The 2.5 mg dose of Mounjaro is intended to get your body used to the medication in order to prevent side effects before moving up to the 5 mg dose where you will begin to see benefits in your blood sugar and A1c readings.

In clinical trials, Mounjaro was shown to provide superior diabetic control over Ozempic and other traditional therapies, such as insulin, across all doses. In these studies, patients’ A1c was measured over a course of 40 weeks of treatment. On average, patient’s being treated with Ozempic 1 mg weekly saw an A1c reduction of 1.9 while patients being treated with Mounjaro 5 mg, 10 mg, or 15 mg weekly saw reductions of 2.0, 2.2, and 2.3 respectively.

While this may not seem like a huge difference, the percentage of participants reaching their A1c goal of below 7% exemplifies how important these minor differences are. Over the 40 weeks, 79% of Ozempic patients reached this A1c goal while 82% of patients on Mounjaro 5 mg weekly and 86% of patients on 10 mg and 15 mg weekly both, reached this goal. Furthermore, only 64% of patients on Ozempic reached an A1c of less than 6.5% while 69% of patients on 5 mg, 77% on 10 mg, and 80% on 15 mg of Mounjaro reached this level.

While Mounjaro is only FDA approved for the treatment of Type II Diabetes in adults, patients enrolled in the clinical trials saw huge benefits in weight loss as well. Below are two graphs depicting the weight loss benefits of the different doses of Mounjaro at the end of the 40 weeks trial. As you can see, the 15 mg dose is extremely beneficial. As a result, some doctors may prescribe this drug for off label use in weight loss although insurance would be unlikely to cover it for that use until there is an FDA approval.

Like all medications, Mounjaro comes with a lengthy list of side effects. The side effects are rare, and most are manageable, however there is one black box warning. This warning is for an increased risk of thyroid c-cell tumors so patients should keep an eye out for symptoms such as a swelling in their neck and have their thyroid function checked regularly. This side effect was only seen in rats and there have been no cases in humans.

For years, first line treatment for diabetes has remained the same with the use of metformin. However, with new and novel drugs like Mounjaro coming to the market, we are beginning to see a shift in recommendations. Depending on compelling conditions that are common in patients with diabetes, such as cardiovascular disease, GLP-1s, and now Mounjaro, are being recommended as first line treatment. If you think you may benefit from this medication, talk to your doctor or pharmacist today!

Sources:

A1C and Weight Change Results | Mounjaro^TM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/a1c-weight

FDA Approves Mounjaro (Tirzepatide) for Diabetes Treatment. diaTribe. Published May 13, 2022. Accessed August 19, 2022. https://diatribe.org/fda-approves-mounjaro-tirzepatide-diabetes-treatment

Getting Started, Dosing & Prescribing | Mounjaro^TM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/getting-patients-started

How Mounjaro Works | Mounjaro^TM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/how-mounjaro-works

Lexicomp. Accessed August 19, 2022. https://online-lexi-com.proxy.lib.ohio-state.edu/lco/action/doc/retrieve/docid/patch_f/7224042?cesid=3danyJdgnJK&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dmounjaro%26t%3Dname%26acs%3Dfalse%26acq%3Dmounjaro

What are GIP & GLP-1 Incretin Hormones | Mounjaro^TM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/what-is-gip