What is the difference between the popular semaglutide and tirzepatide?

semaglutide and tirzepatide are two commonly used GLP-1 receptor agonists, which are widely used in the treatment of type 2 diabetes and obesity. Although they belong to the same class of drugs, there are significant differences in structure and mechanism of action, clinical efficacy, side effects, approved indications, and usage methods.

▍ Mechanism of action

As a GLP-1 receptor agonist, semaglutide mainly stimulates pancreatic beta cells to secrete insulin, increases glucose metabolism, and inhibits pancreatic alpha cells from secreting glucagon, reducing fasting and postprandial blood glucose levels.

nlike this, tirzepatide is a dual target agonist of GLP-1 and GIP. It not only activates GLP-1 receptors, but also mimics the action of natural GIP, leaning towards the production of cAMP rather than the recruitment of β - inhibin on GLP-1 receptors. Compared with GLP-1, the ability oftirzepatide to drive GLP-1 receptor internalization is weaker.

Clinical effect

In clinical studies, semaglutide has shown significant weight loss effects. For example, in the STEP 1 study, after 68 weeks of treatment with a dose of 2.4mg of semaglutide, patients experienced an average weight loss of 14.9%.

tirzepatide showed stronger weight loss effects in phase III studies of SURMOUNT-1 and SURMOUNT-2. The highest dose group of 15mg resulted in an average weight loss of 20.9% for patients, which is approximately 22 kilograms.

side effect

Both drugs, as GLP-1 receptor agonists, may cause similar side effects, mainly gastrointestinal reactions. Common side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, bloating, and indigestion, which usually occur in the early stages of treatment and are mostly mild to moderate symptoms.

However, studies have shown that tilpotide can effectively reduce these side effects due to its effect on GIP receptors, so patients usually feel less side effects and have a stronger sense of satiety.

Approved indications

In addition to the treatment of type 2 diabetes and obesity, semaglutide is also approved for the treatment of obesity in adolescents over 12 years old. tirzepatide has been approved for weight management in China and is suitable for BMI ≥ 28

Obese patients with a BMI of 24-28 kg/m ², or overweight adults with at least one comorbidity.

On July 19, 2024, the National Medical Products Administration (NMPA) issued a notice approving the listing of tirzepatide produced by Eli Lilly and Company (trade name: Mufengda) as a long-term weight management product.

conclusion

In summary, semaglutide and tirzepatide each have their own characteristics in terms of weight loss effects, mechanisms, side effects, and indications. Patients should choose the most suitable treatment plan based on their personal health condition and the doctor's advice.