A class of drugs known as GLP-1 receptor agonists (GLP-1 RAs) have recently garnered significant attention for their potential to promote substantial weight loss. These medications, initially approved by the FDA for diabetes management under names like Ozempic (semaglutide) and Monjaro (tirzepatide), are now being used to combat obesity.
However, despite increased use both on- and off-label, widespread media attention and a need for new tools in the fight against obesity, the real-world effectiveness and safety of these medications outside of clinical trials are still under investigation.
A first-of-its-kind study using real-world data from 41,233 patients, co-authored by Dr. Ty Gluckman from the Providence Center for Cardiovascular Analytics, Research + Data Science (CARDS) and researchers from Truveta, is helping to fill these gaps. Their work was published July 2024 in the Journal of the American Medical Association (JAMA) Internal Medicine and is helping to provide clinicians with robust new evidence on these medications.
Read the full journal article at JAMA, or read on for highlights from the study.
Tirzepatide vs. Semaglutide
While past research has shown tirzepatide produces greater weight loss than semaglutide in patients with type 2 diabetes, data from head-to-head trials comparing these medications in patients without diabetes are not yet available. Moreover, the high cost of these medications and limited insurance coverage can affect adherence to these drugs, potentially diminishing their effectiveness in real-life scenarios. According to Dr. Gluckman, those are some of the reasons this research is so important.
This study sought to address these gaps by comparing on-treatment weight loss and side effects in adults with overweight or obesity with and without type 2 diabetes. The analysis, which leveraged electronic medical record data from Truveta, involved 41,223 patients prescribed either tirzepatide or semaglutide.
Key findings: weight loss, safety & tolerability, discontinuation
The research revealed several significant insights:
- Greater weight loss with tirzepatide: Most adults with overweight or obesity experienced 5% or greater weight loss with either treatment. However, those who took tirzepatide experienced significantly more weight loss compared to those on semaglutide. Patients on tirzepatide were 2.5 times more likely to achieve a 10% reduction in body weight.
- Safety and tolerability: The rates of any gastrointestinal side effects were similar for both drugs.
- Discontinuation was common: 54.2% of the patients in the study data discontinued their GLP-1 RA (≥30 days without medication on hand), highlighting the need for additional research on the role of shortages, adverse events, and costs.
For healthcare providers, this comparative effectiveness study offers important data to inform prescribing decisions.
"Weight loss drugs have the potential to positively impact patients across a wide range of health conditions, including diabetes and cardiovascular disease,” explains Dr. Gluckman. “Our research has important clinical, financial, and health policy implications, as these drugs continue to be regularly discussed in the medical field and popular press."
The impact of real-world data
One key aspect of this research is its use of Truveta data, which draws on electronic medical records (EMRs) across 30 health systems in the U.S., including Providence. This expansive dataset includes over 100 million de-identified patient records, allowing researchers to conduct large-scale analyses using real-world data that complement traditional clinical trials.
Historically, EMR data have been challenging to use for research due to its fragmented, inaccessible, and unstructured nature. Truveta's approach helps overcome these barriers, enabling more comprehensive and meaningful insights into healthcare delivery.
Moving forward
This research marks a significant step towards understanding weight loss medications' real-world use and outcomes. By leveraging extensive data and addressing practical concerns, Dr. Gluckman and his colleagues provide a clearer picture for clinicians and patients alike, guiding better-informed decisions in the fight against obesity.
While this study offers valuable insights, it also underscores the need for further research to explore additional outcomes beyond weight loss. Future studies will help refine our understanding of these medications' long-term effects and their role in managing obesity and related health conditions.
