Real-World Effectiveness of Tirzepatide vs. Semaglutide on HbA1c and Weight in GLP-1 RA Naïve Patients with T2D
Author(s)
Kendra Terrell, MPH1, Carlos R. Vallarino, PhD1, Juan Maldonado Lozada, PharmD1, Michael Grabner, PhD2, Chia-Chen Teng, MS2, Meredith M. Hoog, MPH1, Emma Richard, MPH2;
1Eli Lilly and Company, Indianapolis, IN, USA, 2Carelon Research, Wilmington, DE, USA
1Eli Lilly and Company, Indianapolis, IN, USA, 2Carelon Research, Wilmington, DE, USA
Presentation Documents
OBJECTIVES: The SURPASS-2 (S-2) trial showed tirzepatide is superior to semaglutide in reducing HbA1c and weight in patients with T2D. This is the first real-world study comparing HbA1c and weight change in GLP-1 RA-naïve patients with T2D starting tirzepatide or semaglutide.
METHODS: This retrospective study used claims and clinical data from the Healthcare Integrated Research Database (HIRD®) to identify patients with T2D starting any dose of injectable tirzepatide or semaglutide indicated for T2D between May 13 2022 and May 29 2023. Patients had six months continuous enrollment prior to and 12 months after initiation (index date) and no prior GLP-1 RA fills. Propensity score matching balanced baseline characteristics across cohorts. Changes in prespecified coprimary endpoints, HbA1c and weight, were assessed from baseline (90 days before to 14 days after index) to follow-up (14 days before or after index + 12 months). Analyses were performed on a subgroup of patients with baseline and follow-up data.
RESULTS: Each matched cohort included 10,702 patients. Mean (SD) age was 53.2 (9.94) years for tirzepatide and 53.2 (9.92) for semaglutide. Males comprised 56% of tirzepatide and 55% of semaglutide patients, both cohorts being 71% white and 92% commercially insured. The tirzepatide and semaglutide cohorts had 1,399 and 1,173 patients with both baseline and follow-up HbA1c, respectively, and 454 and 432 patients with baseline and follow-up weight data, respectively. Patients who initiated tirzepatide had significantly greater HbA1c reduction compared to semaglutide initiators ((Mean (SD): -1.3% (1.77) and -0.9% (1.56), P<0.0001, respectively). A similar trend was seen for weight reduction for patients who initiated tirzepatide compared to semaglutide initiators ((Mean (SD): -10.2kg (11.40) and -6.1kg (8.06), P<0.0001, respectively).
CONCLUSIONS: Real-world data shows GLP-1 RA-naïve patients with T2D starting tirzepatide showed greater reduction in HbA1c and weight compared to those starting semaglutide, consistent with S-2 trial findings.
METHODS: This retrospective study used claims and clinical data from the Healthcare Integrated Research Database (HIRD®) to identify patients with T2D starting any dose of injectable tirzepatide or semaglutide indicated for T2D between May 13 2022 and May 29 2023. Patients had six months continuous enrollment prior to and 12 months after initiation (index date) and no prior GLP-1 RA fills. Propensity score matching balanced baseline characteristics across cohorts. Changes in prespecified coprimary endpoints, HbA1c and weight, were assessed from baseline (90 days before to 14 days after index) to follow-up (14 days before or after index + 12 months). Analyses were performed on a subgroup of patients with baseline and follow-up data.
RESULTS: Each matched cohort included 10,702 patients. Mean (SD) age was 53.2 (9.94) years for tirzepatide and 53.2 (9.92) for semaglutide. Males comprised 56% of tirzepatide and 55% of semaglutide patients, both cohorts being 71% white and 92% commercially insured. The tirzepatide and semaglutide cohorts had 1,399 and 1,173 patients with both baseline and follow-up HbA1c, respectively, and 454 and 432 patients with baseline and follow-up weight data, respectively. Patients who initiated tirzepatide had significantly greater HbA1c reduction compared to semaglutide initiators ((Mean (SD): -1.3% (1.77) and -0.9% (1.56), P<0.0001, respectively). A similar trend was seen for weight reduction for patients who initiated tirzepatide compared to semaglutide initiators ((Mean (SD): -10.2kg (11.40) and -6.1kg (8.06), P<0.0001, respectively).
CONCLUSIONS: Real-world data shows GLP-1 RA-naïve patients with T2D starting tirzepatide showed greater reduction in HbA1c and weight compared to those starting semaglutide, consistent with S-2 trial findings.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO23
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)