# Tirzepatide and Serum Uric Acid: A SURMOUNT-1 Post Hoc Analysis | This GLP A SURMOUNT-1 post hoc analysis found serum uric acid fell up to 0.95 mg/dL on tirzepatide against 0.18 on placebo, with 72.7% of the reduction attributed to weight loss. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/uric-acid-fell-and-most-of-it-was-weight Updated: 2026-09-18 Published: 2026-09-17 [← Research](https://thisglp.com/research) Evidence # Tirzepatide and Serum Uric Acid: A SURMOUNT-1 Post Hoc Analysis Serum urate dropped nearly a milligram per deciliter across 72 weeks on tirzepatide, about three quarters of it explained by weight loss. Gout flares were not an outcome. [This GLP Editorial Team](https://thisglp.com/about)September 20266 min readUpdated September 2026 Serum uric acid at week 72, mg/dL lower · tirzepatide 15 mg · −0.95 · tirzepatide 10 mg · −0.92 · tirzepatide 5 mg · −0.69 · placebo · −0.18 · A blood level moved. Gout attacks were not counted. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - A post hoc analysis of SURMOUNT-1 tracked serum uric acid in 2,539 adults with obesity or overweight across 72 weeks. - Uric acid fell 0.69, 0.92 and 0.95 mg/dL on the three tirzepatide doses against 0.18 mg/dL on placebo (all P < .001). - Mediation analysis attributed 72.7% of the reduction to weight loss, leaving about a quarter unexplained. - The fall did not differ by baseline uric acid quartile (P = .610) or baseline BMI (P = .362). High uric acid is what produces gout, and obesity raises it, so a drug that removes a fifth of someone's body weight ought to lower it. A post hoc analysis of SURMOUNT-1 confirmed that and then asked the more interesting question of why [\[1\]](https://thisglp.com/research/uric-acid-fell-and-most-of-it-was-weight#ref-1). The comparison between drug classes on gout itself is in [what a comparator can and cannot tell you](https://thisglp.com/research/do-glp1-drugs-cause-gout). Across 72 weeks, serum uric acid fell by 0.69, 0.92 and 0.95 mg/dL on the 5, 10 and 15 mg doses, against 0.18 mg/dL on placebo. Weight fell by up to 20.9% over the same period, broadly in line with the pooled figures in [the weight-loss averages](https://thisglp.com/research/glp1-weight-loss-pooled-average). Uric acid is a blood test. Gout is an attack. This analysis measured a laboratory value. It reports no gout flares, no new gout diagnoses and no change in urate-lowering prescriptions, because those were not among the outcomes. Lowering serum urate is how gout treatment works, so the direction is encouraging — but a 0.95 mg/dL drop is not a count of attacks avoided, and anyone with gout should read it as a mechanism finding rather than a result about their symptoms. The mediation analysis attributed 72.7% of the uric acid reduction to weight loss. That leaves roughly a quarter attributed to something else about the drug, which is the part worth following up — though as with every mediation analysis, the split is the output of a model resting on assumptions that cannot be tested against the data, the same caution set out in [the liver mediation analysis](https://thisglp.com/research/liver-repair-that-was-not-the-weight). Two nulls in this paper are easy to skim past and shouldn’t be. The reduction did not differ by baseline uric acid quartile (P = .610), so people who started with the highest levels did not drop further than those who started lower. Nor did it differ by baseline BMI (P = .362). That is unusual: most outcomes in this literature show bigger changes in people with more room to move, as [the sleep apnea subgroups](https://thisglp.com/research/apnea-improved-across-every-subgroup) illustrate, and the absence of that pattern here suggests a fairly uniform effect. The practical translation is narrow. If you have gout and are taking one of these drugs for other reasons, your urate is likely to fall, which is the direction gout treatment aims for. If you are considering one specifically for gout, nothing here supports that yet — the trial that would, counting flares rather than measuring blood, has not been done. ## Frequently asked Does tirzepatide treat gout? Not on this evidence. The analysis measured serum uric acid and reported no gout flares, diagnoses or urate-lowering prescriptions, so it shows a mechanism rather than a symptom result. How much did uric acid fall? By 0.69, 0.92 and 0.95 mg/dL on the 5, 10 and 15 mg doses over 72 weeks, against 0.18 mg/dL on placebo. Is it just the weight loss? Mostly. Mediation analysis attributed 72.7% of the reduction to weight loss, leaving about a quarter unexplained — though that split is a model estimate rather than a measurement. ## Sources 1. \[1\] Sattar N, Scilletta S, Stefanski A, Wang H, Daly JW, Linetzky B (2026). Tirzepatide and change in uric acid and its association with weight reduction: post hoc analyses of the SURMOUNT-1 randomised placebo-controlled trial Annals of the Rheumatic Diseases. [PMID 41198460](https://pubmed.ncbi.nlm.nih.gov/41198460/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? 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