Work

Real-World Effectiveness of Tirzepatide versus Semaglutide on HbA1c and Weight in Patients with Type 2 Diabetes

Year: 2025

Type: article

Abstract: To evaluate real-world hemoglobin A1c (HbA1c) and weight change in adults initiating treatment with tirzepatide (dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist [GLP-1 RA]) or injectable semaglutide (GLP-1 RA) indicated for type 2 diabetes (T2D) management. This retrospective analysis utilized the Healthcare Integrated Research Database® to identify adults with T2D starting tirzepatide or injectable semaglutide between May 13, 2022 and May 29, 2023. GLP-1 RA naïve and non-naïve cohorts were identified based on the history of GLP-1 RA use within ≤ 6 months of initiation. Propensity score matching balanced 6-month baseline characteristics between groups. HbA1c and weight changes were assessed from initiation to 12 months for matched patients with HbA1c and weight data at both time points. Both matched naïve cohorts were comprised of 10,702 patients (tirzepatide: 1399 with HbA1c data and 454 with weight data; semaglutide: 1173 with HbA1c data and 432 with weight data). Mean baseline HbA1c and weight were 7.8% and 112.4 kg, respectively, for the tirzepatide group and 7.8% and 110.7 kg for the semaglutide group. Both matched non-naïve cohorts were comprised of 5577 patients (tirzepatide: 792 with HbA1c data and 296 with weight data; semaglutide: 738 with HbA1c data and 224 with weight data). Mean baseline HbA1c and weight were 7.7% and 112.5 kg for tirzepatide, and 7.9% and 108.5 kg for semaglutide. Tirzepatide was associated with greater mean reductions in HbA1c (naïve: – 1.3% vs. – 0.9%; non-naïve: – 0.9% vs. – 0.6%; p < 0.001) and weight (naïve: – 10.2 kg vs. – 6.1 kg; non-naïve: – 7.9 kg vs. – 3.7 kg; p < 0.001) than semaglutide. Patients with T2D starting tirzepatide had greater HbA1c and weight reductions at 12 months post-initiation than those on injectable semaglutide, regardless of previous GLP-1 RA use, consistent with previous clinical trial results. Type 2 diabetes (T2D) is a serious health issue, often linked to other health conditions like obesity. There is little information on the real-world effects of tirzepatide (a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist [GLP-1]) compared to semaglutide (a GLP-1 receptor agonist only) in helping people with type 2 diabetes improve their blood sugar control (HbA1c) and lose weight. This study used real-world data from the Healthcare Integrated Research Database (HIRD®), including adults with T2D who initiated either tirzepatide (Mounjaro®) or semaglutide (Ozempic®). Patients with and without past use of GLP-1 receptor agonists were looked at separately. HbA1c and weight were measured at the start of treatment (baseline) and again after 12 months. After 12 months, people who initiated tirzepatide achieved lower HbA1c levels and lost more weight than those who initiated semaglutide. Among GLP-1 naïve patients, tirzepatide users reduced their HbA1c by 1.3% and lost 10.2 kg, while semaglutide users reduced their HbA1c by 0.9% and lost 6.1 kg, on average. Tirzepatide was also more effective at reducing HbA1c and weight than semaglutide among people with prior GLP-1 receptor agonist use. Clinical trials show how well and how safely medicines work in controlled settings. Once available for use in routine medical practice, real-world studies give additional information about how the medicines work in everyday medical care. This analysis compares two approved medicines used to treat T2D in real life and may help doctors and health leaders make decisions to improve care for people with this condition.

Source: Diabetes Therapy

DOI: 10.1007/s13300-025-01794-9