in ,

Tirzepatide vs Semaglutide – Glycemic and Weight loss Comparison

Tirzepatide vs Semaglutide

tizepatide vs semaglutide

Tirzepatide Vs Semaglutide is a comparison of the two drugs. Tirzepatide is a dual GLP-1 and GIP analog while Semaglutide is a GLP-1 analog.

Tirzepatide is a novel drug that has not yet been approved. It is being investigated for its safety and efficacy in patients with Obesity and Type 2 Diabetes Mellitus.

Wegovy Comparison with Other Weight Loss Drugs

The effects of GLP-1 and GIP:

The two most common incretins that affect glucose and lipid metabolism, and regulate gut motility and appetite are GLP-1 (Glucagon-like peptide 1) and GIP (Glucose-dependent insulinotropic polypeptide).

GLP-1 analogs include Exenatide, Liraglutide, Dulaglutide, and Semaglutide. These drugs cause the release of insulin in a glucose-dependent mechanism and simultaneously suppress glucagon levels.

Unlike GLP-1 analogs, GIP is glucagonotropic in states when the blood glucose is low or normal. It increases the release of glucagon in states of hypoglycemia or normal blood glucose levels.

Wegovy (Semaglutide): Full FDA Prescribing Information

GIP (Glucose-dependent insulinotropic polypeptide) is thought to potentiate the central appetite suppressant effect of GLP-1 analogs. Furthermore, the receptors for GIP are present in abundance in the adipose tissues.

Thus, GIP activation improves post-prandial hyperglycemia by increasing the sensitivity of the adipose tissues to insulin. It also enhances the lipid-buffering capacity of white adipose tissue resulting in the prevention of ectopic fat deposition.

GIP prevents the ectopic fat deposition

Tirzepatide Mechanism of Action: Mounjaro for Diabetes & Weight Loss

What is Tirzepatide?

Tirzepatide is a novel drug. It has a dual mechanism of action. It acts as an incretin-mimetic. However, unlike most of the currently available drugs that primarily target GLP-1, Tirzepatide targets both GLP-1 and GIP.

Tirzepatide is structurally similar to the endogenous Glucose-dependent insulinotropic polypeptide and includes a C20 fatty diacid moiety. Like the latest GLP-1 analogs, it has a long half-life of about five days. It is administered subcutaneously once a week.

Lilly’s Tirzepatide Exceptional Weight Loss Results

Tirzepatide Vs Semaglutide:

The SURPASS Trial (A Study of Tirzepatide [LY3298176] versus Semaglutide Once Weekly as Add-on Therapy to Metformin in Participants with Type 2 Diabetes) evaluated the safety and efficacy of the two drugs in a head to head trial [Ref].

The study was conducted in patients with Diabetes Type 2 who had an inadequate control on metformin monotherapy.

Patients received either Semaglutide 1 mg weekly subcutaneously or Tirzepatide in a dose of 5 mg, 10 mg, and 15 mg subcutaneously once a week.

tirzepatide 5 10 15 mg surpass trial
The SURPASS Trial is a head to head comparison of Tirzepatide in a dose of 5 mg, 10 mg, and 15 mg compared to Semaglutide 1 mg administered weekly

Tirzepatide Vs Trulicity (Mounjaro Vs Dulaglutide)

Efficacy of Tirzepatide Vs Semaglutide in Diabetic Patients:

Tirzepatide was compared in the SURPASS Trial in a head-to-head comparison with Semaglutide. It was observed that the glycated hemoglobin was significantly reduced in patients who were treated with Tirzepatide compared to Semaglutide in a dose-dependent manner.

The HbA1C reduced at week 40 from the baseline by 2.01%, 2.24%, and 2.30% with Tirzepatide 5 mg, 10 mg, and 15 mg compared to Semaglutide 1 mg weekly (1.86%)

percentage hba1c reduction with terzipatide vs semaglutide

Comparison of blood-glucose-lowering effects of Semaglutide vs Tirzepatide

A greater percentage of the patients in the Tirzepatide groups achieved the target HbA1C at week 40 compared to Semaglutide. This is demonstrated here:percentage of patients achieving the target Hba1c in the semaglutide group compared to terzipatide

Percentage of patients in each group achieving the target glycated hemoglobin

Weight loss Comparison of Tirzepatide Vs Semaglutide:

All GLP-1 analogs cause weight loss. The recent STEPS trials demonstrated marked weight loss with high dose Semaglutide 2.4 mg administered once weekly.

Based on the data from the STEPs Trials, it got FDA Approval. The maximum weight loss that occurred in the Wegovy (high-dose Semaglutide 2.4 mg once a week) group was 16%.

Ozempic 2 mg Dose for Weight Loss and Diabetes

The SURPASS Trial compared the 1 mg Semaglutide (Ozempic) administered once a week compared to Tirzepatide at different doses.

It was observed that more weight loss occurred in the Tirzepatide group compared to patients in the 1 mg Semaglutide group.

A weight loss of 5.7 kgs occurred in the Semaglutide group compared to 7.6 kgs, 9.3 kgs, and 11.2 kgs in the Tirzepatide 5 mg, 10 mg, and 15 mg respectively.

weight loss with tirzepatide at week 40 in comparison with semaglutide
Weight loss with Tirzepatide at week 40 in comparison with Semaglutide.

A greater percentage of patients achieved the target weight loss of 5 kgs, 10 kgs, and 15 kgs in the Tirzepatide group compared to patients in the Semaglutide group. This is demonstrated here:

Percentage of Patients Who Met Weight-Loss Target semaglutide vs tirzepatide
Percentage of Patients Who Met Weight-Loss Target Semaglutide vs Tirzepatide

Other effects of Tirzepatide compared to Semaglutide:

Apart from the greater reduction in the HbA1C and significant weight loss of Tirzepatide compared to Semaglutide, it was observed that patients in the Tirzepatide group had a greater improvement in their lipid profiles compared to those treated with Semaglutide.

Change in lipid profile with tirzepatide compared to Semaglutide
Change in lipid profile with Tirzepatide at different doses compared to Semaglutide

Adverse drug reactions were slightly higher in the Tirzepatide group and were dose-dependent compared to Semaglutide.

Most patients had adverse events related to GI symptoms. These included nausea, vomiting, diarrhea, dyspepsia, constipation, flatulence, reduced appetite, and abdominal pain.

How to Get Relief from Persistent Nausea When on Ozempic?

The most common adverse event was nausea and reported in 17.4%, 19.2%, and 22.1% in the Tirzepatide 5 mg, 10 mg, and 15 mg respectively compared to 17.9% in the Semaglutide group.

In Conclusion:

The Novel Drug, Tirzepatide, is a promising drug for the treatment of Diabetes and obesity. It is the first drug that targets both GLP-1 and GIP resulting in greater glycemic control and appetite suppression.

Tirzepatide (Mounjaro): Uses, Dose, MOA, Side effects, Cost

What do you think?

Written by Diabetes Doctor

I am an Internist practicing medicine for the last fifteen years. Over the years, I have learned that medicine is not about prescribing pills. True medical practice is helping people.
I do prescribe pills as well but the best results I get are when I motivate people to overcome their problems with little changes in their lifestyles.
Since most of my patients are obese, have diabetes, hypertension, high cholesterol levels, I am writing at dibesity.com when free.
Dibesity, I know the correct word is diabesity. Ignore this! Be with us.

Leave a Reply

rybelsus vs januvia and janumet weight reduction

Rybelsus vs Januvia and Janumet – Comparing Efficacies

trulicity moa mechanism of action of trulicity

Trulicity MOA (Mechanism of Action of Dulaglutide)