Mounjaro Beats Ozempic for Weight Loss Compared to Real-World Use

In the first head-to-head comparison of two successful drugs in real-world use, people who took Moenjaro lost significantly more weight than their counterparts who Olympic —and the longer the patients continued to take the drugs, the wider the gap became.

After three months of weekly injections, patients receiving Ozempic lost an average of 3.6% of their body weight, while those receiving Mounjaro lost an average of 5.9%.

After six months, the average weight of the Ozempic patients had decreased by 5.8%, while the average weight loss of the Mounjaro patients was 10.1%.

After a full year, people taking Ozempic had lost an average of 8.3% of their weight, while people taking Mounjaro had lost an average of 15.3%.

The researchers who conducted the analysis also found that people taking Mounjaro were 2.5 times more likely to lose at least 10% of their initial weight in the first year of taking the medication, compared with people taking Ozempic. They were more than three times more likely to lose at least 15% of their weight in the first year of taking the medication.

The findings were published Monday in JAMA Internal Medicine.

Dr. Matthew Freebyan endocrinologist and director of the Gonda Diabetes Center at UCLA's Geffen School of Medicine, said the study findings match what he has observed in his own patients.

“From a weight loss perspective and from a sugar lowering perspective for people with type 2 diabetes, we see stronger effects with Mounjaro compared to Ozempic,” said Freeby, who was not involved in the study.

Both medications were approved by the US Food and Drug Administration to help people with diabetes keep their blood sugar levels under control. By a hormone called glucagon-like peptide 1or GLP-1, they stimulate the production of insulinslow digestion, increased feeling of satiety and decreased appetite.

Mounjaro also mimics a related hormone called glucose-dependent insulinotropic peptideor GIP.

When the drugs were compared to placebos in clinical trials, both drugs were found to significantly help patients lose weight. Tirzepatidethe active ingredient in Mounjaro, was found to be more effective than semaglutidethe active ingredient in Ozempic. However, the tests were not conducted under the same conditions, so the results are not directly comparable.

Researchers from Truvetaa healthcare data and analytics company owned by 30 health systemstried to remedy that by examining their trove of electronic medical records. The work also gave them a chance to see how patients fared outside the idealized setting of a clinical trial, which typically offers free medication, regular checkups, and other support.

Using their database, the researchers were able to track down people who had requested their first prescription for either drug between May 2022, the month Mounjaro joined Ozempic FDA Approval Received — and September 2023. Patients did not have to have type 2 diabetes to participate in the study, but they did have to be overweight (with a body mass index of at least 27) or obese (with a BMI of at least 30).

The Truveta team found about 41,000 people in more than 30 states who met all the criteria for inclusion in the study. Because Ozempic patients were three times as numerous as Mounjaro patients, the researchers used information on age, race, income, medical history and other factors to find a group of Ozempic patients that most closely matched the Mounjaro patients. The result was a population of nearly 18,400 who were evenly split between the two drugs.

Before their first dose of the drug, the average weight for people in both groups was 243 pounds. But it didn't take long for the two groups to diverge.

After accounting for unmeasured influences that could have affected the results, the Truveta team found that the amount of weight lost was 2.4 percentage points higher in Mounjaro patients than in Ozempic patients after three months, 4.3 percentage points higher after six months, and 6.9 percentage points higher after one year.

Mounjaro also outperformed Ozempic in the rate at which people achieved several milestones within a year of starting the drug.

Nearly 82% of Mounjaro patients lost at least 5% of their body weight, compared to 67% of patients taking Ozempic. Similarly, 62% of Mounjaro patients and 37% of Ozempic patients lost at least 10% of their starting weight, while 42% of Mounjaro patients and 18% of Ozempic patients lost at least 15% of their starting weight.

The researchers did not investigate the biological mechanisms of the two drugs, but the study's leader Tricia Rodrigueza chief applied scientist at Truveta Research, said Mounjaro may be more effective because it works in two ways rather than one.

Doctor Ken Fujiokaan endocrinologist who heads the Scripps Clinic Nutrition and Metabolic Research Center in San Diego and who was not involved in the study, noted that the FDA approved a higher dose of Ozempic in March 2022, but that many doctors were unaware of it during the study period. With the right dosage, he said, patients on Ozempic would have seen better results.

“I believe Mounjaro produces more weight loss than Ozempic,” said Fujioka, who has received consulting and speaking fees from the makers of both drugs. “I just don’t know exactly by how much.”

The large gap in effectiveness was not accompanied by a measurable difference in the rate of moderate or severe side effects such as bowel obstructions and pancreatitis, which were rare for patients in both groups. The researchers did not compare the risk of milder problems such as nausea and vomiting, because people would not necessarily report these to their doctors, Rodriguez said.

The researchers found that patients with type 2 diabetes, regardless of which drug they took, lost less weight than patients without the disease.

This could be explained by the fact that certain diabetes treatments can cause weight gain, and that some patients eat more during the day to control their blood sugar levels. become too lowsaid Freeby.

DNA is likely a factor, Fujioka added. “People who have the genes to become diabetics probably have the genes to gain weight and maintain it better,” he said.

It's also possible that people who sought a prescription for Ozempic or Mounjaro to lose weight were more motivated to continue taking the drugs, even if they were expensive or had unpleasant side effects, Rodriguez said. It's also possible that they were more likely to engage in other behaviors that promote weight loss.

Figuring this out is “a crucial topic for future research,” she said.

People currently using Ozempic probably have a more pressing question: Should I switch to Mounjaro?

Doctor Nick StuckyAn infectious disease physician at Providence Portland Medical Center and the study's lead author, said the results alone should not lead patients to stop taking a drug that works for them. The risk of side effects, insurance coverage and drug availability are also things to consider.

“Tirzepatide was significantly more effective than semaglutide, but patients taking both drugs experienced significant weight loss,” said Stucky, who is also vice president of research at Truveta.

Freeby agreed.

“If someone is doing well on a drug, why would you want to stir things up?” he said.

Freeby added that Ozempic (and its sister drug Wegovy, which is FDA-approved specifically for weight loss) have at least one advantage over Mounjaro (and Soap-boundits counterpart for weight loss): In clinical studies, Ozempic has been shown to reduce the risk of heart attacks, strokes, and other conditions cardiovascular problems like kidney failure.

“At this point, we don't have a lot of data on Mounjaro in terms of secondary outcomes,” he said.

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