MON-716 Real-world Weight Loss Observed With Semaglutide And Tirzepatide In Patients With Overweight Or Obesity And Without Type 2 Diabetes

Abstract Disclosure: C. Ng: Novo Nordisk. V. Divino: Novo Nordisk. J. Wang: Novo Nordisk. J. Toliver: Novo Nordisk. M. Buss: Novo Nordisk. Introduction: Semaglutide injection 2.4 mg (Wegovy®; hereafter referred to as semaglutide 2.4 mg), a glucagon-like peptide-1 (GLP-1) receptor agonist, was approved by the FDA in 6/2021 for weight management. Tirzepatide, a glucose-dependent insulinotropic polypeptide and GLP-1 receptor agonist, was approved by the FDA in 5/2022 for type 2 diabetes (T2D; Mounjaro®) and in 11/2023 for weight management (Zepbound®). Given the relatively recent approval of these medications, understanding of their real-world, long-term effectiveness is limited. The current study assessed real-world weight loss after 1 year of treatment with semaglutide 2.4 mg or tirzepatide in individuals with overweight or obesity and without T2D in the United States. Methods: This retrospective cohort study included adults with ≥1 pharmacy claim of any dose strength for semaglutide 2.4 mg or tirzepatide in the Komodo Health Dataset between 6/4/2021 and 12/15/2023 (date of treatment initiation was termed the “index date”). Patients were required to have continuous enrollment for 1 year prior to the index date (baseline period) and 1 year after the index date (follow-up period) and to be persistent on therapy (without a gap of >30 days’ supply) over the follow-up period. Patients had either ≥1 diagnosis/record of overweight (BMI 25-29.9 kg/m2) with ≥1 obesity-related complication or ≥1 diagnosis/record of obesity (BMI ≥30 mg/m2). Patients with evidence of T2D during the baseline period or on the index date were excluded. Change in weight from baseline to the end of the 1-year follow-up period was descriptively assessed. Results: A total of 9916 participants were included in the study (semaglutide 2.4 mg, n = 6794; tirzepatide, n = 3122). Baseline characteristics were descriptively similar between the semaglutide 2.4 mg and tirzepatide cohorts: the mean (SD) age was 47.8 (10.3) years and 49.5 (10.9) years, 79.8% and 77.9% of patients were female, and the mean (SD) index weight was 104.5 (22.0) kg and 104.9 (22.7) kg, respectively. After 1 year of follow-up, the mean (SD) absolute weight change was −14.6 (9.9) kg in the semaglutide 2.4 mg cohort and −17.2 (11.7) kg in the tirzepatide cohort, with a mean (SD) percent weight change of −14.1% (9.6) and −16.5% (10.8), respectively. Over the 1-year follow-up period, most (83.5%) patients in the semaglutide 2.4 mg cohort reached the maximum semaglutide dose (2.4 mg), whereas only 25.9% of patients in the tirzepatide cohort reached the maximum tirzepatide dose (15 mg). Conclusions: The patient characteristics observed in this study indicate semaglutide 2.4 mg and tirzepatide are being used in descriptively similar populations. Findings suggest real-world use of both semaglutide 2.4 mg and tirzepatide result in clinically meaningful weight loss after 1 year of treatment. 1 Presentation: Monday, July 14, 2025