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  • Dr. Kim Nester

Semaglutide vs Trizepatide




Type 2 Diabetes Mellitus (T2DM) and obesity are chronic conditions. Both T2DM and obesity have continued to increase worldwide (Chavda et al., 2022; Jastreboff et al., 2022). Obesity is considered the most prevalent chronic disease globally (Jastreboff et al., 2022). The presence of obesity is also a primary contributor to the development of T2DM Chavda et

al., 2022). Traditionally, lifestyle changes have been the primary treatment approach to address obesity (Jastreboff et al., 2022). Alternatively, T2DM has traditionally been treated

using Metformin and is considered a first line treatment modality (Shi et al., 2018). However, over the past several years several new pharmacological management options have been

developed and implemented. This includes Semaglutide, or Ozempic, and Trizepatide, or Mounjaro (Frias et al., 2021). Both medications are marketed to address both T2DM and obesity (Frias et al., 2021). The following will briefly compare these pharmacological options for the treatment of obesity and T2DM.


Semaglutide (Ozempic)


Semaglutide, commonly known as Ozempic, is a glucagon like pertide-1 (GLP-1) receptor agonist (Mahapatra et al., 2022). The medication can be provided in an oral dosage or subcutaneously with a once weekly injection (Mahapatra et al., 2022). Ozempic has demonstrated success in reducing HbA1c levels while also reducing body weight (Mahapatra et al., 2022). One benefit noted is the reduction of these factors without risk of hypoglycemia

(Mahapatra et al., 2022; Shi et al., 2018). One meta-analysis of RCTs conducted found that the Ozempic was able to reduce these factors without an increase in adverse side effects such as pancreatitis (Shi et al., 2018). However, Shi et al (2018) note an increased risk of gastrointestinal disorders, making this medication inappropriate for individuals with preexisting gastrointestinal disorders.


Trizepatide (Mounjaro)


Trizepatide, also known as Mounjaro, is a dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) receptor agonist (Chavada et al., 2022). It is the only medication in its class currently that can reduce glycemic levels, enhance insulin sensitivity, improve lipid metabolism, and reduce body weight by over 20% (Chavada et al., 2022). This

medication is offered subcutaneously in once-weekly injections (Jastreboff et al., 2022). The most common adverse effect includes mild to moderate gastrointestinal symptoms (Jastreboff et al., 2022). According to Chavada et al (2022) Mounjaro is considered a revolutionary medication to manage T2DM and achieve weight loss.



Similarities and Differences


Ozempic and Mounjaro both offer patients a treatment that addresses T2DM and obesity (Chavada et al., 2022; Mahapatra et al., 2022). Both also offer a once-weekly injection, though Ozempic also offers an oral dosage option (Jastreboff et al., 2022; Mahapatra et al., 2022). Mounjaro stands out in its ability to address insulin sensitivity and lipid metabolism

(Chavada et al., 2022). Both medications can result in adverse gastrointestinal symptoms (Chavada et al., 2022; Jastreboff et al., 2022; Shi et al., 2018). One study comparing the

effectiveness of both options found that Mounjaro was superior in achieving weight loss and in reducing glycemic levels (Chavada et al., 2022). This option may therefore be a more

beneficial option for patients with T2DM and obesity in the future.



References


Chavda, V. P., Ajabiya, J., Teli, D., Bojarska, D., Tirzepatide, a New Era of Dual-Targeted Treatment for Diabetes and Obesity: A Mini-Review, V. (2022). Tirzepatide, a new era of dual-targeted treatment for diabetes and obesity: A mini-review. Molecules, 27, 1-10. https://doi.org/10.3390%2Fmolecules27134315


Frías, J. P., Davies, M. J., Rosenstock, J., Pérez Manghi, F. C., Fernández Landó, L., Bergman, B. K., Liu, B., Cui, X., Brown, K. (2021). Tirzepatide versus Semaglutide once weekly in patients with type 2 diabetes. New England Journal of Medicine, 385(6), 503-515.


Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., Stefansk, A. (2022). Tirzepatide once

weekly for the treatment of obesity. New England Journal of Medicine, 387(3), 205-216.


Mahapatra, M. K., Karuppasamy, M., Sahoo, B. M. (2022). Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Reviews in Endocrine and Metabolic Disorders, 23, 521-539.


Shi, F. H., Li, H., Cui, M., Zhang, Z. L., Gu, Z. C., Liu, X. Y. (2018). Efficacy and safety of once-weekly Semaglutide for the treatment of type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Pharmacology, 9(576), 1-13.

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