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Brilliant Board Review & CME
🎙️ Brilliant Medicine: Your Internal Medicine Edge
Stay sharp, stay current, and stay confident with Brilliant Medicine — the go-to podcast for Internal Medicine and Family Medicine physicians, residents, nurse practitioners, and physician assistants.
Each episode delivers high-yield insights on the latest breakthroughs, practice-changing guidelines, and cutting-edge treatments in Internal Medicine — with just enough board review to keep your clinical reasoning razor-sharp.
We cut through the noise, simplify complex studies, and translate new data into actionable knowledge for your daily practice. Whether you're prepping for boards or staying ahead in clinic, hospital, or telemed — we've got your back.
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Brilliant Board Review & CME
🎙️ Episode 35: Tirzepatide Tackles HFpEF and Obesity
💊 Study:
SURMOUNT-HF trial — patients with obesity and HFpEF.
Tirzepatide = ↓ HF hospitalizations and ↑ quality of life.
📈 Benefits:
Significant weight loss.
Better metabolic profiles.
GI side effects: ~6% (nausea, diarrhea).
🧩 Clinical Takeaway:
A major contender for cardio-metabolic syndrome with HFpEF.
More than just a diabetes or weight-loss drug.
Now let's talk about trusepidide. And we get excited when there's a medication for heart failure with preserved ejection fraction because we don't have that many and not many have been proven to do much during clinical trials and we have look at this, this is part of the horseman of the apocalypse Heart failure. Look at this Obesity and you can also say probably diabetes, in the trusepid type group possibly. Remember this is a diabetes medication that really is great for heart failure and kidney disease. So remember, trusepid type is a glucose-dependent, insulin-trophic polypeptide and a GLP-1 receptor agonist.
Speaker 1:Now in this study the patients had elevated BMPs or pro-BMPs. Whatever they used, they had a heart failure exacerbation within 12 months prior or a decrease less than 70 GFR. They're randomized to once-weekly subcutaneous tricep epitone up to 50 mg or placebo for 52 weeks and a median follow-up of 104 weeks, or placebo for 52 weeks and a median follow-up of 104 weeks. Compared to placebo tricep at the time significantly fewer primary endpoints. So, okay, what were they? Heart failure was better and cardiovascular death significantly 10 versus 15% in tricep at the time versus placebo. And they want to see how these patients feel. So they do this Kansas City cardiovascular questionnaire. It's a clinical summary score and patients said they significantly felt better. It was better at seven points and assessed at 52 weeks.
Speaker 1:Now what were the adverse events? Well, one of the adverse events with true type is GI symptoms. So in the trusepid type group it was 6% versus placebo is 1%, and that's concurrent with the data that we have with trusepid type. If you can tolerate the adverse GI effects, this medication may help you lose weight and it may help you with your preserved ejection fraction, heart failure or diastolic heart failure. Pretty amazing, we don't have many medications for diastolic heart failure, so this is a good thing.