To evaluate the association between tirzepatide use and the incidence of pulmonary embolism and deep vein thrombosis in patients with type 2 diabetes and obesity.
Approach:
Study Design: A population-based retrospective cohort study using the TriNetX US Collaborative Network.
Cohort Selection: Adults with type 2 diabetes and overweight or obesity who initiated tirzepatide were matched to patients receiving lifestyle intervention alone.
Outcome Measures: Incidence of pulmonary embolism, deep vein thrombosis, and superficial vein thrombosis within 30 days to 12 months after treatment initiation.
Statistical Analysis: Propensity score matching and landmark sensitivity analysis were employed, along with an active comparator analysis against semaglutide.
Key Findings:
Tirzepatide use was associated with a significantly lower 12-month risk of pulmonary embolism compared to lifestyle intervention alone (RR, 0.215; 95% CI, 0.185–0.250; HR, 0.258; 95% CI, 0.222–0.299).
A similar reduction in risk was observed for deep vein thrombosis (RR, 0.303; 95% CI, 0.270–0.340; HR, 0.361; 95% CI, 0.322–0.406).
No significant difference was found for superficial vein thrombosis (RR, 0.716; 95% CI, 0.484–1.060; HR, 0.868; 95% CI, 0.586–1.286).
Findings for pulmonary embolism and deep vein thrombosis remained significant in the 90-day landmark analysis.
In the semaglutide comparator analysis, tirzepatide showed a significantly lower risk of deep vein thrombosis.
Interpretation:
Tirzepatide use is associated with a lower risk of pulmonary embolism and deep vein thrombosis in patients with diabetes and obesity compared to lifestyle intervention alone.
Limitations:
The study is retrospective and may be subject to biases inherent in observational studies.
The cohort may not represent all patients with type 2 diabetes and obesity.
Conclusion:
Tirzepatide is associated with lower rates of thromboembolic events in the studied population.
