1437 - Semaglutide versus Tirzepatide on Weight Loss in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis

Excess body weight is estimated to affect over 1.1 billion adults across the globe and is considered the leading risk factor for type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as an efficacious treatment for T2DM and have demonstrated substantial weight loss effects. This systematic review aims to compare two prevalent GLP-1 RAs, semaglutide and tirzepatide, with their weight loss effects and rates of adverse events (AEs).

Design:

A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed in PubMed, Embase, and Cochrane Library for direct comparative studies between semaglutide and tirzepatide. A meta-analysis was conducted using SPSS program version 29 to analyze the differences in weight loss outcomes between study cohorts.

Results:

Four studies, with 20,492 patients (10,705 tirzepatide/9757 semaglutide), whose mean age was 56.2 years (43.1 to 63.7) and mean follow-up of 26.1 weeks (12.8 to 40) was included in this study. Mean weight change across the four studies for tirzepatide and semaglutide was  –11.0 % (-15.3 to –7.6 %) and –7.5 % (-8.3 to -6.08 %), respectively. Mean changes in fat mass for tirzepatide and semaglutide were -12.58 kg (-15.5 to -9.7) and -9.22 kg (-12.53 kg to -5.9 kg) , respectively. The most common AEs were minor and moderate-severity gastrointestinal (GI) AEs.

Conclusions:

Current literature supports tirzepatide demonstrating a higher impact on weight loss compared to semaglutide, with both demonstrating high rates of minimal to moderate severity AEs. The paucity of direct comparative studies prevents a definitive conclusion of the superiority of tirzepatide, but the current results are promising. Further research with comparative head-to-head trials will better elucidate these weight loss effects and safety profiles.