Has a king of the GLP-1s finally been crowned? Full results from the SURMOUNT-5 trial published in NEJM seem to suggest that Eli Lilly’s tirzepatide (Zepbound/Mounjarno) could be better than Novo Nordisk’s semaglutide (Wegovy/Ozempic).
- Both tirzepatide and semaglutide are highly effective medications for obesity management.
- However tirzepatide’s efficacy compared to semaglutide in obese adults without T2D was unknown until now.
Weighing the weight loss benefits of each drug, SURMOUNT-5’s researchers randomized 751 obese patients without T2D to receive either tirzepatide (10mg/15mg) or semaglutide (1.7mg/2.4mg) and found that patients on tirzepatide lost far more weight after 72 weeks.
- The average weight loss at week 72 was significantly greater with tirzepatide compared to semaglutide (−20.2% vs. −13.7%).
- Patients on tirzepatide also lost more waist circumference (−18.4 cm vs. −13.0 cm).
- Tirezepatide also had fewer discontinuations due to gastrointestinal events (2.7% vs. 5.6%) and fewer vomiting adverse events (15.0% vs. 21.3%).
While Lilly takes the weight loss cake, the GLP-1 game is quickly becoming about more than just raw weight loss, with several studies in the last few years touting the cardiac benefits of Novo’s semaglutide.
- TRANSFORM-AF recently showed that semaglutide could help reduce AFib events.
- The STRIDE trial uncovered that semaglutide improves the impact of PAD.
- The SELECT trial found that overweight or obese patients with CVD reduced their risk of MACE on semaglutide.
- Results from SELECT were so strong that Novo eventually used them to secure FDA approval and payor reimbursement for semaglutide’s CV event reduction indication.
Meanwhile, tirzepatide’s SUMMIT trial found it reduced mortality risks in HFpEF patients with obesity, but Lilly has since pulled its request to the FDA to approve tirzepatide for HF.
- It’s also worth noting that SURMOUNT-5 and the other SURMOUNT trials are funded by Lilly.
The Takeaway
SURMOUNT-5 confirms what many have suspected for a while – tirzepatide leads to more weight lost than semaglutide in the same amount of time. Whether or not that advantage will sway prescribers and patients remains to be seen.
