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Type 2

Mounjaro Superior to Ozempic for Blood Glucose Control and Weight Loss

Tirzepatide (sold as Mounjaro) is more effective than semaglutide (Ozempic) for both blood glucose control and weight loss, according to a new analysis.

The diabetes drug tirzepatide (brand name Mounjaro) is better than semaglutide (brand names Ozempic) when it comes to controlling blood sugar as well as losing body weight, according to a meta-analysis presented at the 59th European Association for the Study of Diabetes in Hamburg, Germany.

In an oral presentation, Dr. Thomas Karagiannis, a researcher at the Aristotle University of Thessaloniki in Greece, discussed a new meta-analysis of 22 randomized controlled trials totaling 18,472 participants with type 2 diabetes.

The analysis found that the high, medium, and low doses of tirzepatide approved for type 2 diabetes (15 mg, 10 mg, and 5 mg) were more effective in reducing A1C when compared against the respective high, medium, and low doses of subcutaneous semaglutide approved for type 2 diabetes (2 mg, 1 mg, and 0.5 mg). In addition, even 5 mg of tirzepatide – the lowest approved dose of Mounjaro – was more effective in reducing body weight than 1 mg and 0.5 mg doses of injectable semaglutide.

In a treatment ranking for A1C reduction, Karagiannis and his team ranked the following treatments in order of effectiveness, from most effective/best treatment to least effective/worst treatment:

 Ranking Treatment and weekly dosage if applicable
  1  Tirzepatide 15 mg
  2  Tirzepatide 10 mg
  3  Semaglutide 2.0 mg
  4  Tirzepatide 5 mg
  5  Semaglutide 1.0 mg
  6  Semaglutide 0.5 mg
  7  Basal insulin
  8  Other GLP-1
  9  Placebo


Tirzepatide 15 mg was the most efficacious in reducing A1C when compared with placebo (mean difference -2.00%), followed by tirzepatide 10 mg (-1.86%) and semaglutide 2.0 mg (-1.62%).

Karagiannis noted that the meta-analysis does have some limitations: It was focused solely on studies featuring patients with type 2 diabetes, as opposed to people with type 1 diabetes or obesity without type 2 diabetes; it was not done formally using validation tools; additional trials have been published since the analysis was completed; there has been scant literature comparing tirzepatide with the highest dose of semaglutide (2.0 mg).

Karagiannis concluded by noting that there are other variables to consider when choosing treatment.

“Ultimate treatment choice does not depend only on those two outcomes but also on additional parameters,” he said, pointing out the importance of cost as a crucial parameter as well. “We know that semaglutide has protective cardiovascular benefits as shown by the SUSTAIN-6 trial … this has to be proven [with tirzepatide] in an ongoing long-term trial, SURPASS-CVOT.”

The meta-analysis is noteworthy as there have been very few randomized controlled trials directly comparing all currently available doses of the two medications.

Tirzepatide has been studied in a number of clinical trials and has shown impressive A1C lowering and weight loss benefits. Those include the SURPASS trials, which includes five completed studies (SURPASS-1 through -5) and five ongoing or recruiting trials (SURPASS-6, SURPASS-CVOT, SURPASS-EARLY, SURPASS-SWITCH, and SURPASS-SWITCH-2). The incretin-based therapy has also been shown to have significant weight loss as well as clinically relevant impact on insulin resistance, liver disease, and obesity.