Indirect comparative efficacy and safety of tirzepatide vs semaglutide for the treatment of obesity or overweight in patients without type 2 diabetes
Authors' conclusion
In this ITC for obesity treatment in adults without T2D, with obesity, or overweight with ≥1 ORC, compared with semaglutide, tirzepatide 10 or 15 mg was associated with improvements in weight reduction, body composition and several cardiometabolic risk factors and generally similar safety profiles.
Study context
- Population
- Adults with obesity (BMI ≥ 30 kg/m²), or overweight (BMI ≥ 27 kg/m²) with ≥1 obesity-related complication, without T2D
- Comparison
- Tirzepatide 5, 10 and 15 mg/week vs semaglutide 2.4 mg/week
- Outcome
- Weight reduction
- Follow-up
- Week 68, STEP 1; Week 72, SURMOUNT-1
Methodological detailsadjusted (for sex, and sex and ethnicity) and unadjusted, via placebo
- Adjusted (for sex, and sex and ethnicity) and unadjusted
- Via placebo
Main finding
As reported in the abstract
Tirzepatide 10 mg
−5.10 kg
CI −6.63, - 3.57
Tirzepatide 15 mg
−6.50 kg
CI −8.03,−4.97
Further findings
| Outcome | Difference (kg/m²) (CI) | |
|---|---|---|
| BMI · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 10 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −1.87 (−2.43,−1.31) | |
| BMI · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 15 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −2.37 (−2.93,−1.81) | |
| −4−202Difference, kg/m² (linear scale) |
| Outcome | Difference (cm) (CI) | |
|---|---|---|
| Waist circumference · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 10 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −5.25 (−6.69,−3.81) | |
| Waist circumference · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 15 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −5.75 (−7.19,−4.31) | |
| −10−505Difference, cm (linear scale) |
| Outcome | Difference (%) (CI) | |
|---|---|---|
| HbA1c · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 10 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −0.08 (−0.13,−0.03) | |
| HbA1c · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 15 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −0.10 (−0.15 to −0.05) | |
| Percentage body fat mass (participants reporting body composition)Tirzepatide 15 mgvs Semaglutide | −3.50 (−6.66 to −0.34) | |
| Percentage body lean mass (participants reporting body composition)Tirzepatide 15 mgvs Semaglutide | 3.40 (0.40–6.40) | |
| −10−50510Difference, % (linear scale) |
| Outcome | Difference (mg/dL) (CI) | |
|---|---|---|
| FPG · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 10 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −1.69 (−3.36,−0.02) | |
| FPG · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)Tirzepatide 15 mgvs SemaglutideEfficacy estimand, unadjusted ITC | −2.52 (−4.19,−0.85) | |
| −6−4−202Difference, mg/dL (linear scale) |
Participants achieving ≥10/15/20% weight reduction · Week 68 (STEP 1) / Week 72 (SURMOUNT-1)
- Tirzepatide 10 and 15 mg: statistically significant improvements vs semaglutide
- Efficacy estimand, unadjusted indirect treatment comparison (ITC)
Tirzepatide 5 mg vs semaglutide (weight, BMI, waist, HbA1c, FPG)
- Tirzepatide 5 mg showed non-significant trends of greater improvements vs semaglutide
Adjusted vs unadjusted comparisons
- Results were broadly consistent across adjusted and unadjusted comparisons
Safety
- Safety profiles of tirzepatide and semaglutide were generally similar
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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