Real-World Effectiveness of Tirzepatide vs. Semaglutide on HbA1c and Weight in GLP-1 RA Experienced Patients with T2D
Author(s)
Meredith M. Hoog, MPH1, Carlos R. Vallarino, PhD1, Juan Maldonado Lozada, PharmD1, Michael Grabner, PhD2, Chia-Chen Teng, MS2, Kendra Terrell, 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-experienced 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 at least one pharmacy claim for a non-index GLP-1 RA during the 6-month pre-index period. 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 5,577 patients. Mean (SD) age was 54.9 (9.24) years for tirzepatide and 55.0 (9.50) for semaglutide. Males comprised 55% of tirzepatide and 54% of semaglutide patients. The tirzepatide and semaglutide cohorts had 792 and 738 patients with both baseline and follow-up HbA1c, respectively, and 296 and 224 patients with baseline and follow-up weight data, respectively. Patients who initiated tirzepatide had significantly greater HbA1c reduction compared to semaglutide initiators ((Mean (SD): -0.9% (1.39) and -0.6% (1.46), P=0.0001, respectively). A similar trend was seen for weight reduction for tirzepatide initiators compared to semaglutide initiators ((Mean (SD): -7.9kg (10.15) and -3.7kg (6.49), P<0.0001, respectively).
CONCLUSIONS: In this real-world database study, GLP-1 RA-experienced 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 at least one pharmacy claim for a non-index GLP-1 RA during the 6-month pre-index period. 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 5,577 patients. Mean (SD) age was 54.9 (9.24) years for tirzepatide and 55.0 (9.50) for semaglutide. Males comprised 55% of tirzepatide and 54% of semaglutide patients. The tirzepatide and semaglutide cohorts had 792 and 738 patients with both baseline and follow-up HbA1c, respectively, and 296 and 224 patients with baseline and follow-up weight data, respectively. Patients who initiated tirzepatide had significantly greater HbA1c reduction compared to semaglutide initiators ((Mean (SD): -0.9% (1.39) and -0.6% (1.46), P=0.0001, respectively). A similar trend was seen for weight reduction for tirzepatide initiators compared to semaglutide initiators ((Mean (SD): -7.9kg (10.15) and -3.7kg (6.49), P<0.0001, respectively).
CONCLUSIONS: In this real-world database study, GLP-1 RA-experienced 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
CO72
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)