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Bariatric Surgery

Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta-analysis

International Journal of Obesity volume 47, pages 677–685 (2023)Cite this article

Subjects

Abstract

Background

Recent studies suggest that tirzepatide, a dual glucose-dependent insulinotropic-peptide (GIP) and glucagon-like peptide-1 receptor agonist (GLP-1 RA), has significant weight loss effects. This systematic review and meta-analysis aims to assess the efficacy and safety of tirzepatide for weight loss in patients with overweight or obesity.

Methods

Medline, Embase and Cochrane CENTRAL were searched for randomized controlled trials (RCTs) on tirzepatide’s weight loss efficacy for these patients. A single arm meta-analysis of proportions estimated primary outcomes, ≥5%, ≥10%, and ≥15% weight loss, and adverse events (AEs); while meta-analysis of means estimated secondary outcomes. Comparative meta-analysis was conducted between tirzepatide and control arms where mean differences and odds ratios were estimated for continuous and dichotomous outcomes respectively.

Results

RCTs included in this study revealed that among 5800 patients, 78.22% (95% CI: 72.15% to 83.73%), 55.60% (95% CI: 46.54% to 64.47%), 32.28% (95% CI: 23.17% to 42.12%) achieved ≥5%, ≥10%, and ≥15% weight loss, respectively. Tirzepatide 5 mg demonstrated weight loss superiority relative to placebo (MD: −12.47 kg, 95% CI: −13.94 kg to −11.00 kg) and semaglutide (n = 1409, MD: −1.90 kg, 95% CI: −2.97 kg to −0.83 kg) with dose-dependent increase for 10 mg and 15 mg doses. The comparison between tirzepatide and semaglutide was examined in the SURPASS-2 trial that was included in this systematic review. For AEs, there was increase odds of experiencing gastrointestinal AEs with tirzepatide compared to placebo, but no significant difference with semaglutide.

Conclusion

Tirzepatide has significant potential as a weight loss drug in patients with overweight and obesity, with little increase in AEs compared to other weight loss drugs. With its ability to concurrently target multiple aspects of metabolic syndrome, it should be considered as the next helm of weight loss therapies.

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Fig. 1: PRISMA flow chart.
Fig. 2: Proportion of Patients that Achieved ≥5%, ≥10%, ≥15% weight loss by Dose of Tirzepatide.

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Data availability

All articles in this manuscript are available from Medline and Embase.

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Acknowledgements

All authors have made substantial contributions to all the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted. No writing assistance was obtained in the preparation of the manuscript. The manuscript, including related data, figures and tables has not been previously published and that the manuscript is not under consideration elsewhere.

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Author notes

  1. These authors contributed equally: Bryan Tan, Xin-Hui Pan.

  2. These authors jointly supervised this work: Cheng Han Ng, Nicholas W. S. Chew, Yip Han Chin.

Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Bryan Tan, Xin-Hui Pan, Rachel Sze Jen Goh, Chaoxing Lin, Kai En Chan, Christen En Ya Ong, Hui Charlotte Chung, Dan Yock Young, Mark Y. Chan, Chin Meng Khoo, Mark Dhinesh Muthiah & Nicholas W. S. Chew

  2. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Han Shi Jocelyn Chew

  3. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    Vickram Vijay Anand & Ethan Cheng Zhe Lee

  4. Ministry of Health Holdings, Ministry of Health, Singapore, Singapore

    Gwyneth Kong, Cheng Han Ng & Yip Han Chin

  5. Department of Cardiology, National University Heart Centre, Singapore, Singapore

    Mark Y. Chan & Nicholas W. S. Chew

  6. Department of Endocrinology, National University Hospital, Singapore, Singapore

    Chin Meng Khoo

  7. VCU Health Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA

    Anurag Mehta

  8. Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore

    Mark Dhinesh Muthiah

  9. National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore

    Mark Dhinesh Muthiah

  10. Cedars-Sinai Fatty Liver Program, Division of Digestive and Liver Diseases, Department of Medicine, Comprehensive Transplant Centre, Cedars-Sinai Medical Centre, Los Angeles, CA, USA

    Mazen Noureddin

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Contributions

Conceptualization—YHC, NWSC, MDM, MN, CHN. Data curation—BT, X-HP, YHC. Formal analysis—YHC, RSJG, CL, VVA, ECZL. Supervision—DYY, MYC, CMK, AM, MDM, MN, CHN, NWSC. Validation—YHC, NWSC, CHN, NWSC. Writing, original draft – BT, X-HP, YHC. Writing, review, and editing—BT, X-HP, YHC, HSJC, RSJG, CL, VVA, ECZL, KEC, GK, CEYO, HCC, DYY, MYC, CMK, AM, MDM, MN, CHN, NWSC. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Corresponding authors

Correspondence to Cheng Han Ng or Yip Han Chin.

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Competing interests

MYC: Speaker’s fees and research grants Astra Zeneca, Abbott Technologies and Boston Scientific. MN: MN has been on the advisory board for 89BIO, Gilead, Intercept, Pfizer, Novo Nordisk, Blade, EchoSens, Fractyl, Terns, Siemens and Roche diagnostic; he has received research support from Allergan, BMS, Gilead, Galmed, Galectin, Genfit, Conatus, Enanta, Madrigal, Novartis, Pfizer, Shire, Viking and Zydus; he is a minor shareholder or has stocks in Anaetos, Rivus Pharma and Viking. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Tan, B., Pan, XH., Chew, H.S.J. et al. Efficacy and safety of tirzepatide for treatment of overweight or obesity. A systematic review and meta-analysis. Int J Obes 47, 677–685 (2023). https://doi.org/10.1038/s41366-023-01321-5

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