SURMOUNT-CN: Tirzepatide in Chinese Adults
Last verified May 2026 · Phase 3 · Finished; headline results published August 2024 · NCT05024032 ↗
Most of what is known about these drugs comes from trials in which participants were predominantly white and predominantly American or European, with mean baseline weights around 100 kg. Chinese populations develop metabolic disease at lower BMI thresholds, which means both the eligibility criteria and the expected response may differ. SURMOUNT-CN is a smaller trial than the main program and was designed to support regional approval, but it addresses a gap that the larger trials structurally cannot.
- Enrollment
- 210
- Duration
- 52 weeks of weekly injections plus standard safety follow-up
- Drug
- Tirzepatide
- Population
- Chinese adults 18 and over with a BMI of 28 or more — or 24 or more if a weight-related condition came with it, meaning high blood pressure, abnormal cholesterol, sleep apnea, heart disease or fatty liver. Type 2 diabetes was an exclusion. 210 people were randomized across 29 centers in China between September 2021 and December 2022, split roughly evenly by sex, averaging 36 years old, 91.8 kg and a BMI of 32.3. ★ 95.7% finished the full year, an unusually high completion rate.
Primary endpoint
How much body weight came off over 52 weeks, and how many lost at least 5%
Treatment arm
15 mg: −17.5% (95% CI −19.7 to −15.3); 10 mg: −13.6% (95% CI −15.8 to −11.4)
Comparator
Placebo: −2.3%
Treatment difference: 15 mg vs placebo: −15.1 percentage points (95% CI −18.2 to −12.1; P<0.001); 10 mg vs placebo: −11.3 percentage points (95% CI −14.3 to −8.3; P<0.001)
★ Nearly nine in ten cleared 5% on either dose, against under a third on placebo. The 17.5% at the top dose comes close to the 20.9% the multinational trial reported — from a leaner starting point, at a BMI of 32.3 against 38.0, and over 20 fewer weeks.
Secondary endpoints
| Endpoint | Treatment | Comparator | Difference |
|---|---|---|---|
| Lost at least a tenth of body weight Three quarters at the top dose — the threshold where sleep apnea, fatty liver and blood sugar tend to improve. | 15 mg: 77.5%; 10 mg: 64.4% | Placebo: 9.5% | P<0.001 for both tirzepatide doses vs placebo |
| Lost at least 15% A clear majority at the top dose reached the band that starts to overlap sleeve gastrectomy at one year. | 15 mg: 60.6%; 10 mg: 42.5% | Placebo: 2.4% | P<0.001 for both tirzepatide doses vs placebo |
| Lost at least a fifth ⚠ Read the placebo column: not one person on placebo got here, against nearly half at the top dose. That is about as stark as a comparison gets. | 15 mg: 43.7%; 10 mg: 22.6% | Placebo: 0% | P<0.001 for both tirzepatide doses vs placebo |
| Weight lost in kilograms ★ The row most likely to be misread. 15.9 kg looks small against the 23.6 kg the multinational trial reported — but participants here started 13 kg lighter. As a percentage the two are much closer, and percentage is what matters clinically. | 15 mg: −15.9 kg; 10 mg: −12.6 kg | Placebo: −2.1 kg | Treatment difference at 15 mg: −13.8 kg vs placebo |
| Inches off the waist About 13 cm at the top dose, similar to the multinational trials, and especially relevant in a population where fat around the middle drives risk at lower body weights. | 15 mg: −13.1 cm; 10 mg: −10.7 cm | Placebo: −2.7 cm | Treatment difference at 15 mg: −10.4 cm vs placebo |
| Top blood-pressure number Down 5 to 6 points, roughly what adding a low-dose blood-pressure tablet achieves. | 15 mg: −6.5 mmHg; 10 mg: −5.4 mmHg | Placebo: −0.2 mmHg | Treatment difference at 15 mg: −6.3 mmHg vs placebo |
| Three-month average blood sugar ⚠ Nobody here had diabetes, so this moves within the normal-to-prediabetic band rather than treating anything. | 15 mg: −0.46%; 10 mg: −0.45% | Placebo: −0.05% | Treatment difference at 15 mg: −0.41 percentage points vs placebo |
| Fasting insulin level Down more than 40%. This is the clearest indication in the table that insulin resistance improved rather than just weight falling. | 15 mg: −45.5%; 10 mg: −41.0% | Placebo: −5.5% | Treatment difference at 15 mg: −40.0 percentage points vs placebo |
| Triglycerides, a blood fat Down about a quarter against 3% on placebo. | 15 mg: −26.3%; 10 mg: −22.7% | Placebo: −3.4% | Treatment difference at 15 mg: −22.9 percentage points vs placebo |
| Non-HDL cholesterol, which captures all the artery-damaging fractions ⚠ A 6% reduction — real but small. Nothing in this class replaces a statin for someone who needs one. | 15 mg: −5.9%; 10 mg: −6.6% | Placebo: −0.5% | — |
Adverse events
| Event | Treatment rate | Comparator rate |
|---|---|---|
| Nausea The leading complaint, mostly mild to moderate, and bunched into the weeks when the dose was rising. Overall stomach-and-bowel rates looked like the multinational trials. | 15 mg: 32.4%; 10 mg: 22.9% | Placebo: 13.0% |
| Diarrhea Second most common, and usually passing. | 15 mg: 22.5%; 10 mg: 21.4% | Placebo: 14.5% |
| Loss of appetite Logged as a side effect by convention, though it is how the drug works rather than something going wrong. | 15 mg: 19.7%; 10 mg: 17.1% | Placebo: 2.9% |
| Constipation About 14% on either dose against 4% on placebo. | 15 mg: 14.1%; 10 mg: 14.3% | Placebo: 4.3% |
| Vomiting Rose with the dose, from about 9% to about 13%. | 15 mg: 12.7%; 10 mg: 8.6% | Placebo: 2.9% |
| Bloating Roughly three times the placebo rate, and minor. | 15 mg: 8.5%; 10 mg: 8.6% | Placebo: 2.9% |
| Stopped the drug over a side effect ★ Under 5%, close to placebo, in a trial where 95.7% of everyone enrolled completed the full 52 weeks. High tolerability, not just high efficacy. | Tirzepatide arms pooled: <5% | Placebo: comparable low rate |
| Serious adverse events of any kind No excess over placebo, and no deaths during the year of treatment. | 15 mg: 5.6%; 10 mg: 4.3% | Placebo: 4.3% |
Clinical significance
The result is broadly consistent with SURMOUNT-1 in direction and magnitude, which supports generalizing the drug's effect across populations. ⚠ At 210 participants it is small, and one regional trial does not settle generalizability across every population that was underrepresented in the pivotal work — which remains a real limitation of the evidence base for this whole class rather than a criticism of this trial.
Who sells tirzepatide, and for how much
This trial tested Tirzepatide. Across the 556 sellers on this register, 253 publish a standing monthly cash price for compounded tirzepatide, from $99 a month, with a median of $240.
⛔ None of those sellers was in this trial. A compounded preparation is not the product studied here: no agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and its concentration is set by whichever pharmacy filled it. The result above is the strongest evidence available for tirzepatide and it was generated on something else. Every seller, with its price record.
Frequently Asked Questions
References
- 1.Zhao L, Cheng Z, Lu Y, Liu M, Chen H, Zhang M, Wang R, Yuan Y, Li X. Tirzepatide for Weight Reduction in Chinese Adults With Obesity: The SURMOUNT-CN Randomized Clinical Trial. JAMA. 2024. PMID: 38819983.
- 2.U.S. National Library of Medicine. A Study of Tirzepatide (LY3298176) in Participants With Obesity or Overweight in China (SURMOUNT-CN) — Study Record. ClinicalTrials.gov, NCT05024032. 2024. https://clinicaltrials.gov/study/NCT05024032
- 3.WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004. PMID: 14726171.
- 4.Zhou BF; Cooperative Meta-Analysis Group of the Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults — study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci. 2002. PMID: 12046553.
- 5.Jastreboff AM, Aronne LJ, Ahmad NN, et al.; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022. PMID: 35658024.
- 6.Mu Y, Bao X, Eliaschewitz FG, et al.; STEP 7 Study Group. Efficacy and safety of once weekly semaglutide 2.4 mg for weight management in a predominantly east Asian population with overweight or obesity (STEP 7): a double-blind, multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2024. PMID: 38330988.
- 7.Gao L, Lee BW, Chawla M, et al. Tirzepatide versus insulin glargine as second-line or third-line therapy in type 2 diabetes in the Asia-Pacific region: the SURPASS-AP-Combo trial. Nat Med. 2023. PMID: 37231074.