Real-World Comparison of Short-Term Adverse Events, Treatment Persistence, and Efficacy of Semaglutide and Tirzepatide: A Nationwide Multicenter Study.
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Hepşen Sema, Haymana Cem, Ertepe Küçükgöde Gizem, Özcan Büşra, Özbaş Burak, Or Koca Arzu, Aydoğan Berna İmge, Tura Bahadır Çiğdem, Durcan Emre, Yumuk Volkan, Toros Bora, Alphan Üç Ziynet, Önder Çağatay Emir, Karaca Karagöz Zuhal, Aşık Mehmet, Öztürk Yusuf, Kocabaş Muhammet, Karaköse Melia, Bostan Hayri, Kıyıcı Sinem, Salman Serpil, Gogas Yavuz Dilek, Göksoy Solak Yağmur, Daloğlu Osman Onur, Eren Mehmet Ali, Doğanay Şahin, Güven Mehmet, Kaplan Gizem Ilgın, Cesur Mustafa, Demir Önal Eda, Ertek Yalçın Sibel, Ağbaht Kemal, Baloğlu Akyol Elif Melis, Genç Selin, Özer Özge, Şimşek Yasin, Topaloğlu Ömercan, Acıbucu Fettah, Bozdoğan Mehmet Emin, Karagün Barış, Emral Rıfat, Tan Sinem Başak, İnce Yahya Erdem, Akkuş Gamze, Cansu Güven Barış, Saltabaş Mehmet Akif, Çakır Bekir, Karaahmetli Gülsüm, Alkan Samet, Demirpençe Mustafa, Taşkaldıran Işılay, Tanrıkulu Seher, Bozkırlı Emre, Turgut Seda, Dereli Akdeniz Didem, Gültekin Arif Cengiz, Cerit Ethem Turgay, Omma Tülay, Can Bülent, Soylu Hüseyin, Uzun Yusuf Emre, İpekçi Süleyman Hilmi, Telci Çaklılı Özge, Ünal Mehmet Çağrı, Elbüken Gülşah, İçin Buket Büşra, Kır Yusuf, Batman Adnan, Güney Sedat Can, Ertürk Banu, Akhanlı Pınar, Çatak Merve, Kargılı Çarlıoğlu Ayşe, Güzel Esen Sakine, Doğruel Hakan, Yıldız İsmail, Özsoy Kübra, Demirci İbrahim, Çakal Erman, Bayram Fahri, Sönmez Alper
Аннотация
METHODS: This study included 2,549 patients with obesity treated with semaglutide (n = 1,434) or tirzepatide (n = 1,115). Adverse events, including time to onset, dose at occurrence, and related discontinuation, were evaluated. Changes in BWL and metabolic parameters up to 6 months were assessed. Subgroup analyses were performed in patients with and without type 2 diabetes mellitus (T2DM).
RESULTS: At least one adverse event occurred in 50.9% in the semaglutide group and 51.0% in the tirzepatide group (p = 0.524), with gastrointestinal events the most frequently reported. Overall adverse event rates were comparable between groups; however, musculoskeletal and allergic reactions were more common in the tirzepatide group. The onset of gastrointestinal, neuropsychiatric, musculoskeletal symptoms, and hypoglycemia occurred earlier in the tirzepatide group. Discontinuation due to adverse events was similar between groups, except for pancreatic events, which were more frequent in the semaglutide group (p = 0.006). Tirzepatide was associated with greater early BWL at all time points. At 6 months, median percentage BWL was 12.6% with semaglutide and 14.4% with tirzepatide. HbA1c reductions were comparable between groups in patients with T2DM.
CONCLUSION: In real-world clinical practice, semaglutide and tirzepatide show similar short-term tolerability and treatment persistence, although tirzepatide is associated with a higher incidence of musculoskeletal and allergic reactions and greater early BWL.