Tirzepatide 15 mg is the ‘most efficacious’ for weight loss among GLP-1 agonists
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Key takeaways:
- Tirzepatide was associated with the highest degree of weight loss compared with placebo and other GLP-1 agonists.
- There was no difference in the percentage of weight loss at tirzepatide 15 mg and 10 mg doses.
VANCOUVER, British Columbia — Tirzepatide 15 mg was associated with the highest degree of weight loss compared with other glucagon-like peptide-1 agonists and placebo, according to a presenter at the ACG Annual Scientific Meeting.
“GLP-1 agonists act in the hypothalamus to increase satiety; in the gut they delay gastric emptying and in the pancreas they upregulate insulin secretion,” Jena Velji-Ibrahim, MD, MSc, of Prisma Health Greenville Memorial Hospital, said. “There are currently two GLP-1 agonists that have FDA approval for obesity management: liraglutide and semaglutide. Other GLP-1 agonists have been approved for type 2 diabetes management.”
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Velji-Ibrahim continued: “While clinical trials have been conducted to assess the weight loss efficacy of GLP-1 agonists, there have been limited head-to-head comparisons and the data that have been obtained have been quite inconsistent.”
In a systemic review and network meta-analysis, Velji-Ibrahim and colleagues analyzed 17 randomized controlled trials, which included nearly 22,000 adults (BMI ≥ 27) with obesity-related comorbidities, to assess weight loss effects of GLP-1 agonists tirzepatide, semaglutide, liraglutide and dulaglutide compared with placebo.
“In total, we have 10 treatments excluding placebo when different dosages are considered,” Velji-Ibrahim noted.
Results showed all GLP-1 agonists — except dulaglutide 0.75 mg — were linked with a reduction in percentage weight change compared with placebo, with the greatest effect reported with tirzepatide 15 mg (mean = –20.1%; 95% CI, –21.98 to –18.22). However, researchers observed no difference in the percentage of weight loss between tirzepatide 15 mg and 10 mg (mean = –1.1%; 95% CI, –2.98 to 0.78), suggesting the medication could be used at either dose for optimal effect.
At a probability of 98%, tirzepatide 15 mg was the first-ranked treatment for weight loss.
“Tirzepatide 15 mg is an appealing option for weight management,” Velji-Ibrahim concluded. “It was the most efficacious medication in individuals who are obese or overweight without type 2 diabetes. We also show a similarity of results between oral and subcutaneous semaglutide, meaning that we have another option when we consider GLP-1 agonists for obesity management.”
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Velji-Ibrahim J, et al. GLP-1 agonists and their efficacy for weight loss: Unraveling the best option through network meta-analysis. Presented at: ACG Annual Scientific Meeting; Oct. 20-25, 2023; Vancouver, British Columbia (hybrid meeting).
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