Real-world weight impact upon tirzepatide discontinuation at a single-center endocrinology clinic in patients with overweight or obesity.

BACKGROUND: Overweight and obesity are major contributors to cardiovascular-kidney-metabolic (CKM) disease. Tirzepatide (TZP-MJ), originally approved for type 2 diabetes (T2D), has demonstrated significant weight loss beyond glycemic improvement. Despite these benefits, real-world medication access barriers may lead to abrupt therapy discontinuation. Currently, there is a lack of real-world data of TZP-MJ discontinuation in outpatient settings. OBJECTIVES: To assess the real-world impact of TZP-MJ discontinuation on body weight in patients with overweight or obesity managed in an endocrinology and weight management clinic with clinical pharmacist support. METHODS: A 12-month, single-center retrospective study in adult patients with obesity or overweight with a weight-related comorbidity and active prescription for TZP-MJ from 5/13/2022-6/30/2023 for > 3 months prior to discontinuation. Primary outcome was percent change in body weight 12-months following TZP-MJ discontinuation. Secondary outcomes included rates of transitioning to alternate obesity medications (OMs). RESULTS: 83 patients met inclusion criteria and had remained on TZP-MJ for a mean of 11 months, achieving a mean body weight reduction of 6.7%. The most common reason for TZP-MJ discontinuation was due to medication access related due to cost (80.7%). At 12-months following TZP-MJ discontinuation, mean body weight change was not statistically significant (+1.9%, p=0.11). Most patients transitioned to alternative OMs (n=68; 81.9%) CONCLUSION: Although TZP-MJ is associated with meaningful weight loss, medication cost is a barrier to therapy continuation. In real-world practice, weight loss achieved on TZP-MJ may be sustained by transitioning to alternate OMs to mitigate potential rebound weight gain following discontinuation, demonstrating a critical role for clinical pharmacists.