Tirzepatide real world data from England beat semaglutide on glucose and weight goals
A retrospective study presented at EASD 2026 found that 46.3% of adults with type 2 diabetes starting tirzepatide reached HbA1c below 6.5% at 12 months, against about one in five on semaglutide, GlobalData reported.
What's new
A retrospective, propensity matched study of English primary care records found more adults with type 2 diabetes reached HbA1c below 6.5% and 15% weight loss on tirzepatide than on injectable or oral semaglutide.
Why it matters
It suggests the advantage seen in the SURPASS-2 trial carries into routine care, though the study is observational and its patient numbers and safety data are not public.
What's next
A full abstract or paper with patient counts, discontinuation and safety data is needed before the result can be weighed properly.
New tirzepatide real world data from England suggest more adults with type 2 diabetes reach glucose and weight goals on Lilly's tirzepatide than on Novo Nordisk's semaglutide. The retrospective study, presented at the European Association for the Study of Diabetes meeting and summarised by the analytics firm GlobalData on October 14, compared people newly started on tirzepatide, injectable semaglutide or oral semaglutide. After 12 months, 46.3 percent of tirzepatide users had glycated haemoglobin below 6.5 percent. The comparison is observational, and key details have not been published.
What the England data show
GlobalData said the study used primary care records from England and propensity score matching, a statistical method that pairs people with similar characteristics across the drug groups. The three groups were adults with type 2 diabetes starting Mounjaro, the tirzepatide brand, Ozempic, the injectable semaglutide brand, or Rybelsus, the semaglutide tablet. Two goals were tracked at 12 months. The first was glycated haemoglobin, a three month average of blood glucose, below 6.5 percent. The second was a loss of at least 15 percent of body weight. On both goals, the share of tirzepatide users who reached the target was roughly double the share on either form of semaglutide.
| Goal at 12 months | Tirzepatide | Injectable semaglutide | Oral semaglutide |
|---|---|---|---|
| Glycated haemoglobin below 6.5% | 46.3% | 20.6% | 23.8% |
| Weight loss of at least 15% | 24.1% | 9.1% | 8.4% |
The gap on weight was wide. About one in four tirzepatide users lost at least 15 percent of their body weight, against fewer than one in ten on injectable or oral semaglutide, according to GlobalData's summary. Oral semaglutide did slightly better than the injection on glucose control and slightly worse on weight loss. "The data demonstrate tirzepatide's greater real-world effectiveness across two important T2D treatment goals," said Maria Alexandrovich, a pharma analyst at GlobalData. Longevity.Technology reported the findings on October 26. The figures are proportions of people reaching a threshold, not average changes, so they say nothing about how far each group moved on glucose or weight in absolute terms.
How the study was done and what is missing
Several basic facts are not in the public summaries. GlobalData did not give the number of patients in each group, the name of the database, the study authors or their institutions. It did not report side effects, how many people stopped or switched treatment during the year, or what doses were used. The analytics firm is not the study team, and the abstract itself was not available to check. These gaps limit how much weight the numbers can bear. A reader cannot tell whether the result rests on a few hundred patients or on tens of thousands, and that changes how precise the percentages are.
A reader cannot tell whether the result rests on a few hundred patients or on tens of thousands, and that changes how precise the percentages are.
Observational designs carry a second limit. Propensity matching balances the factors that were recorded, such as age, weight and starting glucose, but it cannot balance factors that were not. In routine care, doctors choose a drug for reasons that may also shape outcomes, including how motivated a patient seems, supply at the pharmacy or local prescribing rules. People on a newer drug may also differ in ways that records do not capture. Such studies are useful for checking whether trial results hold in everyday practice, but they cannot prove that one medicine causes better outcomes than another. Alexandrovich said further evidence will be needed to see whether the benefits hold.
How tirzepatide real world results fit the trial evidence
The direction of the England data matches the main head to head trial. In SURPASS-2, published in the New England Journal of Medicine in 2021, 1,879 adults with type 2 diabetes were randomly assigned to one of three tirzepatide doses or to weekly semaglutide in an open label, 40 week phase 3 study. Tirzepatide lowered glycated haemoglobin more than semaglutide at every dose tested and produced greater weight loss. Randomization removes the selection problems that affect record based studies, which is why trials remain the stronger evidence. The new tirzepatide real world analysis adds a different kind of information: whether the advantage persists outside a trial, over a full year, in ordinary practices.
Tirzepatide acts on two hormone receptors, GIP and GLP 1, while semaglutide acts on the GLP 1 receptor alone. That dual action is the usual explanation offered for its larger effect on weight. Both drugs are approved for type 2 diabetes, and both are peptides given by injection, apart from the semaglutide tablet. The summary names only the diabetes brands, Ozempic and Rybelsus, so the result should be read as a diabetes comparison and not as a verdict on the obesity products. The GlobalData analysis frames the result as a market question as much as a clinical one, in a crowded incretin field.
What comes next for the comparison
The next step is publication of the full abstract or a peer reviewed paper with patient numbers, follow up rates and safety data. Until that happens, the news report from Longevity.Technology and the GlobalData note are the only public accounts. Alexandrovich said the data could help differentiate tirzepatide from semaglutide in an increasingly competitive market. Clinicians already weigh glucose control and weight against side effects, cost and supply, and none of those were reported here. Readers tracking how trial results compare with routine care can follow our trials desk for publications and readouts. Each day's filings on incretin drugs also appear on the daily newswire.
There is also a measurement question. Thresholds such as a glycated haemoglobin below 6.5 percent are strict, and many guidelines set individual targets that are less tight for older people or those at risk of low blood sugar. A drug that helps more people cross a strict line may still bring smaller gains for some groups. Weight loss of 15 percent is a demanding benchmark more typical of obesity trials than of diabetes care. These choices are reasonable, but they shape the headline numbers. Full results should also show average changes, the share of people who stopped treatment and any differences by age, sex or starting weight.
Conclusion
The tirzepatide real world data from England point the same way as the randomized SURPASS-2 trial: more people reached strict glucose and weight goals on tirzepatide than on semaglutide. But the findings come from an observational study known so far only through an analyst's summary, without patient numbers, safety data or named authors. Until the full results are published, they are a signal worth watching rather than settled evidence.
