{
 "checked": "2026-10-26",
 "page": "https://jabbitapp.com/research/zepbound-vs-wegovy-tirzepatide-semaglutide-head-to-head-teardown.html",
 "news": {
  "reuters_2026_10_26": {
   "url": "https://www.streetinsider.com/Reuters/US+judge+wont+block+Eli+Lilly+ads+for+weight-loss+drugs%2C+rules+against+Novo+Nordisk/27234058.html",
   "note": "Reuters report (Jonathan Stempel), syndicated by StreetInsider. The 25-page decision itself was not yet on the public docket when checked.",
   "quotes": [
    "said Novo Nordisk did not deserve a preliminary injunction, having failed to show that Eli Lilly's ads threatened sales, undermined its goodwill, or caused lasting damage to its clinical reputation.",
    "\"inadequate to warrant the extraordinary relief it seeks.\"",
    "by comparing higher doses of those products with lower doses of Novo Nordisk's Wegovy and Ozempic.",
    "people using Zepbound on average lost 50 pounds (23 kg) while people using Wegovy on average lost 33 pounds (15 kg).",
    "Eli Lilly, based in Indianapolis, has denied wrongdoing and said it was pleased with the decision.",
    "Novo Nordisk and its lawyers did not immediately respond to requests for comment.",
    "In his 25-page decision",
    "with prescriptions for Novo Nordisk's products remaining stable",
    "money damages could compensate Novo Nordisk for any \"nontrivial harm\""
   ]
  },
  "docket_3_26_cv_09027": {
   "url": "https://dockets.justia.com/docket/new-jersey/njdce/3:2026cv09027/603726",
   "quotes": [
    "Filed: July 21, 2026",
    "15 U.S.C. § 1125",
    "STEP UP Publication",
    "SURMOUNT-5 Publication",
    "FDA Approval Letter Wegovy 7.2 mg",
    "FDA Approval Letter Ozempic 2 mg",
    "SURPASS 2 Publication",
    "Decision Reserved."
   ]
  },
  "lilly_2025_05_11": {
   "url": "https://investor.lilly.com/news-releases/news-release-details/zepbound-tirzepatide-showed-superior-weight-loss-over-wegovy",
   "quotes": [
    "Participants using Zepbound lost an average of 50.3 lbs (22.8 kg) and participants on Wegovy lost an average of 33.1 lbs (15.0 kg).",
    "However, the study was not powered to compare the safety and tolerability of Zepbound and the safety and tolerability of Wegovy.",
    "Dr. Aronne also serves as a paid advisory board member for Novo Nordisk",
    "Not controlled for family-wise type 1 error rate."
   ]
  },
  "fda_2026_03_19": {
   "url": "https://www.fda.gov/news-events/press-announcements/fda-approves-fourth-product-under-national-priority-voucher-program-higher-dose-semaglutide",
   "quotes": [
    "the higher dose resulted in additional average weight reduction compared to previously approved doses",
    "Reports of altered skin sensation (described as sensitivity, pain, or burning) were common, occurred more frequently at the higher Wegovy dosage than lower dosages",
    "The FDA is currently conducting further investigations regarding this drug reaction."
   ]
  }
 },
 "labels": {
  "zepbound_dailymed_setid": "487cd7e7-434c-4925-99fa-aa80b1cc776b",
  "zepbound_quotes": [
   "WARNING: RISK OF THYROID C-CELL TUMORS",
   "It is unknown whether ZEPBOUND causes thyroid C-cell tumors",
   "to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity."
  ],
  "wegovy_dailymed_setid": "ee06186f-2aa3-4990-a760-757579d8f77b",
  "wegovy_quotes": [
   "WARNING: RISK OF THYROID C-CELL TUMORS",
   "It is unknown whether WEGOVY causes thyroid C-cell tumors",
   "to reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established CV disease and either obesity or overweight.",
   "for the treatment of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH)"
  ],
  "note": "Zepbound's Indications section (checked Oct 26, 2026) lists weight reduction and OSA; it does not list a cardiovascular-event indication."
 },
 "surmount5_full_text_table3": [
  "Serious adverse events 18 (4.8) 13 (3.5) 31 (4.1)",
  "Adverse events leading to death 0 0 0",
  "Discontinuation of the trial treatment because of adverse events 23 (6.1) 30 (8.0) 53 (7.1)",
  "Nausea 163 (43.6) 167 (44.4)",
  "Vomiting 56 (15.0) 80 (21.3)",
  "Injection-site reaction 32 (8.6) 1 (0.3)",
  "is that the trial was not blinded"
 ],
 "surmount5_thresholds_lilly": [
  {
   "threshold": "At least 10% weight loss",
   "tirzepatide_pct": 81.6,
   "semaglutide_pct": 60.5
  },
  {
   "threshold": "At least 15%",
   "tirzepatide_pct": 64.6,
   "semaglutide_pct": 40.1
  },
  {
   "threshold": "At least 20%",
   "tirzepatide_pct": 48.4,
   "semaglutide_pct": 27.3
  },
  {
   "threshold": "At least 25%",
   "tirzepatide_pct": 31.6,
   "semaglutide_pct": 16.1
  }
 ],
 "surmount5_mean_pct": {
  "tirzepatide": -20.2,
  "semaglutide": -13.7
 },
 "registry": {
  "NCT05556512": {
   "acronym": "SURMOUNT-MMO",
   "status": "ACTIVE_NOT_RECRUITING",
   "enrollment": 15374,
   "primary_completion_estimated": "2027-10",
   "sponsor": "Eli Lilly and Company"
  }
 },
 "abstract_quotes": {
  "40353578": {
   "title": "Tirzepatide as Compared with Semaglutide for the Treatment of Obesity",
   "journal": "N Engl J Med",
   "quotes": [
    "In this phase 3b, open-label, controlled trial",
    "A total of 751 participants underwent randomization.",
    "-20.2% (95% confidence interval [CI], -21.4 to -19.1) with tirzepatide and -13.7% (95% CI, -14.9 to -12.6) with semaglutide (P<0.001)",
    "The most common adverse events in both treatment groups were gastrointestinal, and most were mild to moderate in severity and occurred primarily during dose escalation.",
    "Funded by Eli Lilly; SURMOUNT-5"
   ]
  },
  "34170647": {
   "title": "Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes",
   "journal": "N Engl J Med",
   "quotes": [
    "we randomly assigned 1879 patients",
    "In an open-label, 40-week, phase 3 trial",
    "Tirzepatide at all doses was noninferior and superior to semaglutide.",
    "Serious adverse events were reported in 5 to 7% of the patients who received tirzepatide and in 3% of those who received semaglutide.",
    "Funded by Eli Lilly; SURPASS-2"
   ]
  },
  "42670242": {
   "title": "Comparative Efficacy of Tirzepatide Versus Semaglutide for Weight Loss in Adults With Overweight or Obesity: A Systematic Review and Meta-Analysis of Head-to-Head Studies",
   "journal": "Clin Obes",
   "quotes": [
    "Ten studies including 41 381 participants were analysed.",
    "(MD -4.28 percentage points; 95% CI -5.28 to -3.28; p < 0.00001)",
    "There was no significant difference in treatment discontinuation due to adverse events (RR 1.28; p = 0.54), whereas serious adverse events were more frequent with tirzepatide (RR 1.83; p = 0.007).",
    "Overall and gastrointestinal adverse events were similar between groups.",
    "We included randomised controlled trials and observational studies"
   ]
  },
  "42897521": {
   "title": "Current status of anti-obesity medications and performance, an EHR based survey",
   "journal": "BMC Endocr Disord",
   "quotes": [
    "Tirzepatide and Semaglutide outperformed other AOMs and were associated with up to 9·6[IQR:11]% and 6·2[IQR:11]% weight loss, respectively",
    "The median exposure durations were approximately 4·6 months for the two GLP-1/GIP AOMs, far short of the 72-week duration typically required for peak therapeutic benefit in RCTs.",
    "while Tirzepatide led both cohorts, nearly 50% and 25% of individuals didn't achieve the 10% and 5% weight loss target respectively, after a minimum 72 weeks exposure",
    "71,318 (11·7%) and 1 M (27·9%) individuals documented AOM exposures"
   ]
  },
  "42673585": {
   "title": "Efficacy and Safety of Glucagon-like Peptide-1 Receptor Agonists and Co-agonists for Weight Loss Among Adults Without Diabetes : An Updated Systematic Review",
   "journal": "Ann Intern Med",
   "quotes": [
    "Thirty-eight RCTs (n = 25 816) were included",
    "-14.8% (CI, -16.2% to -13.4%) for subcutaneous semaglutide",
    "-19.0% (CI, -21.6% to -16.4%) for tirzepatide",
    "greater weight loss with tirzepatide and cagrilintide-semaglutide (CagriSema; Novo Nordisk) than semaglutide",
    "Heterogeneity precluded quantitative synthesis."
   ]
  },
  "42688617": {
   "title": "Comparative efficacy and safety of glucagon-like peptide 1 based drugs for weight loss in adults with overweight or obesity without diabetes: network meta-analysis of randomised controlled trials",
   "journal": "BMJ Med",
   "quotes": [
    "58 trials of 24 214 participants were analysed.",
    "followed by tirzepatide (-19.28%, -20.39% to -18.16%)",
    "Differences in tolerability, limited head-to-head evidence, and residual uncertainty, however, should be considered when interpreting comparative treatment effects."
   ]
  },
  "42806056": {
   "title": "Indirect comparative efficacy and safety of tirzepatide vs semaglutide for the treatment of obesity or overweight in patients without type 2 diabetes",
   "journal": "Int J Obes (Lond)",
   "quotes": [
    "This indirect treatment comparison (ITC) assessed the relative efficacy and safety of tirzepatide versus the GLP-1 RA semaglutide.",
    "Safety profiles of tirzepatide and semaglutide were generally similar."
   ]
  },
  "42002673": {
   "title": "Reversion to normoglycemia with tirzepatide vs semaglutide in participants with obesity and prediabetes: a post hoc analysis of SURMOUNT-5",
   "journal": "J Endocrinol Invest",
   "quotes": [
    "A greater proportion of tirzepatide-treated participants reverted to normoglycemia (89.9%) vs semaglutide (76.2%).",
    "Participants (N = 425) with baseline prediabetes"
   ]
  },
  "41865857": {
   "title": "Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis",
   "journal": "Am J Med",
   "quotes": [
    "Overall, 32.3% were rapid responders (tirzepatide: 44%, semaglutide: 21%).",
    "this did not affect rates of study treatment completion relative to non-rapid responders"
   ]
  },
  "42434924": {
   "title": "Tirzepatide compared with semaglutide in obesity disease: a subpopulation analysis applying Japan Society for the Study of Obesity criteria in the global SURMOUNT-5 trial",
   "journal": "Curr Med Res Opin",
   "quotes": [
    "Of 750 participants, 383 met the criteria for obesity disease"
   ]
  },
  "42768828": {
   "title": "Real-World Adverse Event Reporting Patterns of Tirzepatide Versus Semaglutide: A Stratified Study of General and Healthcare Professional Cohorts in FAERS",
   "journal": "Diabetes Obes Metab",
   "quotes": [
    "tirzepatide showed higher hypoglycaemia reporting (RORR 1.91, 95% CI 1.49-2.44)",
    "all findings are hypothesis-generating and require confirmation with defined exposure denominators"
   ]
  },
  "40961952": {
   "title": "Once-weekly semaglutide 7·2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial",
   "journal": "Lancet Diabetes Endocrinol",
   "quotes": [
    "STEP UP was a phase 3b, randomised, double-blind, placebo-controlled and active-controlled trial conducted across 95 hospitals, specialist clinics, and medical centres in 11 countries in adults with BMI 30 kg/m2 or greater, without diabetes.",
    "1407 participants were randomly assigned",
    "Serious adverse events were reported by 68 (6·8%) of 1004 participants",
    "FUNDING] Novo Nordisk"
   ]
  }
 },
 "conflict_statements": {
  "42670242": "The authors declare no conflicts of interest.",
  "42897521": "Competing interests: The authors declare no competing interests.",
  "42806056": "Employee and shareholder of Eli Lilly and Company",
  "41865857": "Louis J. Aronnereports receiving grants or personal fees from"
 },
 "analysis": {
  "note": "Jabbit analysis. The only randomized head-to-head trial in obesity without diabetes (SURMOUNT-5, Lilly-funded, open-label, 751 people, 72 weeks) favored tirzepatide by 6.5 points of body weight; a 10-study meta-analysis (41,381 people, trials and observational studies) found 4.28 points; real-world records show a smaller absolute gap and short median use. Serious adverse events were numerically higher on tirzepatide in SURMOUNT-5 and SURPASS-2 and significantly higher in the meta-analysis; discontinuation for side effects was not different. Wegovy HD (FDA, Mar 19, 2026) has not been tested head-to-head against tirzepatide. No trial has compared deaths, heart attacks or strokes between the two drugs."
 }
}