Study: Tirzepatide produces greater weight loss vs. other GLP-1s
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Key takeaways:
- A dose of 15 mg tirzepatide produced a mean weight loss of 15% in patients after a year of treatment.
- Some of the GLP-1s in the study have not yet been approved specifically for obesity treatment.
Tirzepatide and injectable semaglutide were associated with the greatest weight loss after a year of treatment among several GLP-1 receptor agonists, a recent study showed.
“Despite being the most recent medication approved for weight loss, tirzepatide [Zepbound, Eli Lilly] showed the greatest weight loss among the GLP-1 medications studied,” Kristen Bartelt, RN, a clinician at Epic Research, told Healio.
In the study — which was not peer reviewed — the researchers examined a cohort of 413,557 patients who had been prescribed tirzepatide, liraglutide (Saxenda, Novo Nordisk), dulaglutide (Trulicity, Eli Lilly), injectable semaglutide (Wegovy, Novo Nordisk) or oral semaglutide (Rybelsus, Novo Nordisk) for a minimum of 180 days.
Bartelt and colleagues stratified patients by the peak dosage of the medication prescribed within a year of GLP-1 treatment “to determine how dosage might influence the amount of weight loss experienced.”
The cohort included patients with and without diabetes.
Overall, the highest doses of all GLP-1 medications produced greater median weight loss a year after treatment initiation vs. their respective lower doses, whereas patients on any dosage of tirzepatide or injectable semaglutide experienced greater weight loss than those on any dosage of dulaglutide, liraglutide or oral semaglutide.
Specifically, patients on 5 mg, 10 mg and 15 mg tirzepatide had a median weight loss of 8.6%, 13.2% and 15%, respectively.
Meanwhile, patients on 1 mg, 1.7 mg, 2 mg and 2.4 mg injectable semaglutide had a median weight loss of 4.5%, 6%, 5.9% and 10%, respectively.
The median weight loss from doses of oral semaglutide, liraglutide and dulaglutide ranged between 1.7% and 3.8%.
“For primary care physicians, these findings suggest that the choice of GLP-1 medication and its dosage can significantly influence the weight loss outcomes of their patients,” Bartelt said.
She added that some of the medications and dosages — including oral semaglutide, dulaglutide, 0.6 mg liraglutide and 1 mg and 2 mg injectable semaglutide — have not yet been approved by the FDA for the treatment of obesity and “are more likely to have been prescribed for diabetes management.”
Perspective
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A huge population was studied (413,000) that compared the effects of different weight loss medications. Dulaglutide, liraglutide, semaglutide and tirzepatide. It's been known that semaglutide and tirzepatide are more effective, but more research has been needed to confirm wheter tirzepatide is more efficacious overall. Previous research has mostly been done on patients with diabetes, so this research is incredibly important because a more diverse group of individuals was studied thanks to the large sample size.
What's also important is that this study separated individuals by socioeconomic status, ethnicity if they are rural or urban dwelling, and even what their primary mode of transportation is to reduce sampling bias. This looks like an observational study though, so we can't rule out if these confounding factors may have influenced the final results. For example, tirzepatide is often a more expensive medication up front, so those who receive it may be of higher socioeconomic status and thus have less environmental factors that contribute to obesity or diabetes pathogenesis.
One strength of this study was that it broke down the median weight loss after 1 year by peak dosage, which shows us that a higher dosage of injectable semaglutide was more efficacious overall than a smaller dose of tirzepatide. Previous studies that have compared these medications did not give a breakdown of these doses or equal doses of these medications.
Because of these results, it's possible we may see more frequent tirzepatide prescriptions for weight loss. Up until recently, only semaglutide has been approved for weight loss (tirzepatide was just approved for type 2 diabetes) And because tirzepatide not only helps manage hunger but also insulin creation, this could be an incredibly important drug for those with pre-diabetes. Because the similar side effects of these medications, we may see a shift in the popularity of these drugs as more clinicians are educated on tirzepatide showing more promising impacts on weight loss and blood sugar management.
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Tirzepatide and injectable semaglutide correlated with greatest weight loss among GLP-1 medications. https://www.epicresearch.org/articles/tirzepatide-and-injectable-semaglutide-correlated-with-greatest-weight-loss-among-glp-1-medications. Published March 14, 2024. Accessed March 19, 2024.
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