The Journal of the American Medical Association (JAMA) recently published a new investigation that explored if semaglutide and tirzepatide – GLP-1 drugs that are highly popular for the treatment of diabetes and obesity – reduce the risk of hospitalization for heart failure or all-cause mortality in patients with obesity-related heart failure with preserved ejection fraction and type 2 diabetes.
The investigation utilized five cohort studies using national US health care claims data from 2018 to 2024. Two cohort studies emulated semaglutide and tirzepatide clinical trials to benchmark results. Eligibility criteria were then expanded to evaluate treatment effects in patients typically treated in clinical practice. Finally, a head-to-head comparison of tirzepatide and semaglutide was implemented. Follow-up was up to 52 weeks.
In analyses using expanded eligibility criteria, 58 333 patients were included in the semaglutide vs sitagliptin cohort, 11 257 for tirzepatide vs sitagliptin, and 28 100 for tirzepatide vs semaglutide. Initiators of semaglutide and tirzepatide had substantially lower risk of the primary end point compared with sitagliptin.
Patients initiating semaglutide or tirzepatide had a more than 40% lower risk of hospitalization for heart failure or all-cause mortality compared with sitagliptin (a glucose-lowering drug with no effect on heart failure end points).
In a head-to-head comparison, tirzepatide showed no meaningful benefit over semaglutide.
These findings complement early results from small clinical trials and support the use of semaglutide and tirzepatide in patients with cardiometabolic heart failure with preserved ejection fraction.
Furthermore, other organizations such as the American Heart Association, Frontiers in Clinical Diabetes and Healthcare, and the American College of Cardiology, also believe that GLP-1 antagonists have the potential to reduce cardiovascular risks in patients with type 2 diabetes, but these organizations still agree that more research is necessary.
