Tirzepatide vs. Semaglutide: Tina Thethi, MD, Details the Differences Seen in Diabetes, Obesity

The ongoing buzz of conversation around GLP-1 receptor agonists (RAs), like semaglutide, and now the GLP-1 RA and GIP (glucose-dependent insulinotropic polypeptide) receptor combination drug tirzepatide, reached a summit at Pri-Med Midwest 2022. The meeting commenced just after the FDA announcement that tirzepatide was granted Fast Track designation for treating adults with obesity, or overweight with weight-related comorbidities.

"So, tirzepatide and the trials that it has had so far, the SURPASS trials and the SURMOUNT trials, has shown weight loss," Tina Thethi, MD, MPH, Associate Investigator, AdventHealth Research Institute, explained in an interview with HCPLive just before she took the stage for her talk on “Where Are We Now? The Integral Role of GLP-1 RAs in the Treatment of Type 2 Diabetes Mellitus” with Frank Lavernia, MD.

"In fact, the weight loss seen with tirzepatide is more than the weight loss seen with semaglutide," she continued. "However, as much as I make this comparison, I must say that all GLPs do help with weight loss across the board to varying degrees and the varying doses."

Tirzepatide has already achieved FDA approval for the treatment of type 2 diabetes and it's pending a decision for the indication of obesity. While the data for this once-weekly injection is promising, the drug's comprehensive dataset is incomplete and there are still investigations underway, specifically regarding cardiovascular outcomes.

"With semaglutide, I should make note, also saying that we have cardiovascular outcome data on subcutaneous semaglutide. However, the definitive cardiovascular outcome trial for oral semaglutide, the RYBELSUS, is still ongoing," Thethi said.

During the interview, she explained what's currently known about the treatment options and their various ongoing investigations, giving guidance on how to navigate the choices when deciding how to treat a presenting patient.

"But with the data so far with tirzepatide, it definitely has shown improvement in A1c, weight loss, and all of these are risk factors for cardiovascular disease as well," she continued. "So, that being said—yes, (tirzepatide) certainly can be used, but if you're using it for a specific indication for cardiovascular protection, then we can certainly use the agents that have that indication as well."

For more from Dr. Tina Thethi, watch the rest of her interview.