Real-World Evidence โคSupports Similar Cardiovascular Benefits of Tirzepatide and Semaglutide
Despite promising results from clinical trials, determining the optimal choice โbetween tirzepatide and semaglutide for patients with cardiovascular risk remains challengingโ due to a lack of direct comparative data. To address this gap,โข researchers analyzed data from five large cohort studies encompassing individuals with elevated cardiovascular risk – including obesity and type 2 diabetes – enrolled in U.S. insurance โprograms between 2018 andโฃ 2025.
The study employed a multi-facetedโ approach. First, researchers recreated the designs of two key cardiovascular outcome โtrials – SUSTAIN-6 (semaglutide vs.sitagliptin) and SURPASS-CVOT (tirzepatide vs. dulaglutide) – to validate โฃtheir methods.This “benchmarking” process showed strong alignment between the real-world data โanalysis and the original trial results for most outcomes, โขwith a minor discrepancy observed in all-cause mortality within โthe SUSTAIN-6 emulation.
Next, the researchers evaluated theโฃ effectiveness of each drug individually in broader patient populations representative of those encountered in routine clinical practice. Semaglutide demonstratedโข a statistically significant reduction in the risk of myocardial infarction orโฃ stroke compared to sitagliptin (hazard ratio 0.82, 95% CI 0.74-0.91). Tirzepatide showed a trend towards reduced risk of โฃa composite outcome including mortality compared to dulaglutide, though this did โnot โreach statistical meaning (hazard ratio โฃ0.87, 95% CI 0.75-1.01).
Crucially, a direct comparison of tirzepatide and semaglutide revealed no significant difference in โcardiovascular outcomes (hazard ratio 1.06, 95% CI โ0.95-1.18).
These โขfindings suggest that bothโฃ tirzepatide and semaglutide offerโ comparable cardiovascular benefits in a real-world setting. This researchโฃ highlights the value of rigorously conducted observational studiesโฃ in supplementing evidence from randomized controlled trials and informing clinical decision-making.