medRxiv

Semaglutide and tirzepatide for weight loss: How do they stack up?

November 29, 2023

In a real-world study of U.S. adults with overweight or obesity, who initiated tirzepatide or semaglutide formulations labeled for T2DM, tirzepatide recipients were significantly more likely to achieve 5%, 10%, and 15% weight loss and experience larger weight reductions at 3, 6, and 12 months.

• Adults with overweight or obesity first dispensed semaglutide or tirzepatide between May 2022 and September 2023 were identified from a large EHR dataset linked with comprehensive Rx dispensing data. The cohort was restricted to patients with no prior GLP-1 RA exposure, who initiated a formulation of semaglutide or tirzepatide labeled for T2DM (a proxy for dose), received regular care in the previous year, had a GLP-1 RA prescription written in the 60 days prior to initiation, and had an available baseline weight.
• 41,223 patients were included in the cohort: semaglutide: 32,030; tirzepatide: 9,193. Researchers used propensity score matching to produce an analytic cohort of 18,386 patients who were well balanced on all baseline covariates. At treatment initiation, mean age was 52.0 years, 70.5% of patients were female, 51.7% had T2DM, and mean weight was 110 kg.
• A larger proportion of patients on tirzepatide vs. semaglutide achieved weight reductions ≥5% (81.8% vs. 64.6%), ≥10% (62.1% vs. 38.0%), and ≥15% (42.3% vs 19.3%) within 1 year of treatment initiation (hazard ratios of 1.76 for 5%, 2.42 for 10%, and 3.04 for 15% weight loss.
• Tirzepatide recipients experienced larger changes in percentage of body weight lost at 3 months (difference, −2.3%), 6 months (−4.3%), and 12 months (−7.2%). Hazards for all GI adverse events were similar between groups

Source:

Rodriguez PJ, et al. (2023, November 27). medRxiv. Comparative Effectiveness of Semaglutide and Tirzepatide for Weight Loss in Adults with Overweight and Obesity in the US: A Real-World Evidence Study. https://www.medrxiv.org/content/10.1101/2023.11.21.23298775v1.full