ECO 2026: Real-World Comparison of Short-Term Adverse Events, Treatment Persistence, and Efficacy of Tirzepatide and Semaglutide: A Nationwide Multicenter Study

Presenter

Hepşen, S.

Currently, there is a dearth of real-world data comparing safety, tolerability, and effectiveness of semaglutide (SEMA) and tirzepatide (TIR) in patients with obesity. This nationwide multicenter study compared short‑term adverse events, discontinuation, body weight loss (BWL), and metabolic outcomes between SEMA and TIR in patients with obesity.

The study population comprised of 2,549 patients with obesity (SEMA, n=1,434, median treatment duration: 16 weeks; TIR, n=1,115, median treatment duration: 12 weeks). Adverse events, predominantly, gastrointestinal occurred in 50.9% of the patients in the SEMA group and 51.0% in the TIR group (TIR; p=0.524). Treatment discontinuation due to pancreatic events were more frequent with SEMA (p=0.006), others were comparable. At 6 months, patients in the TIR group achieved greater reduction in median BWL, as compared to those in the SEMA group (14.4% vs. 12.6%), with higher proportions of patients achieving ≥5%, ≥10%, and ≥15% loss in the TIR group. Treatment with SEMA was associated with greater reductions in fasting plasma glucose and low-density lipoprotein cholesterol at 6 months, and a modest increase in high-density lipoprotein cholesterol, as compared to TIR. The changes in other glucose and lipid parameters were similar between groups. The median HbA1c reduction at 6 months was −0.9% and −0.8% in the SEMA and TIR groups, respectively. Overall, the tolerability was comparable, but TIR yielded greater early BWL.

33^rd European Congress on Obesity (ECO 2026), 12^th -15^th May 2026, Istanbul, Turkey.