Aamir Ahmad Bin, Latif Rabia, Alqoofi Jood Faisal, Almarzoq Fatimah Abdulkarim, Fallatah Joory Osamah, Hassan Ghala Abdullah, Saab Fatimah Abbas Abdullah Al Abu
Punjab Medical College, Faisalabad Medical University, Faisalabad, Pakistan.
Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
J Clin Med Res. 2025 May;17(5):285-296. doi: 10.14740/jocmr6231. Epub 2025 May 13.
The aim of the study was to compare the effectiveness of tirzepatide versus semaglutide in producing weight loss.
A systematic search was conducted in databases PubMed, Scopus, and Web of Science on January 22, 2025, using search terms ("tirzepatide," "semaglutide," and "weight loss") and their alternatives, which yielded 751 studies in total. After deduplication, title/abstract and full text screening was conducted, and studies were assessed based on the eligibility criteria. After extracting the data, a meta-analysis (MA) was performed through RStudio. Heterogeneity among studies was evaluated with Cochran's Q and I tests. A random-effect model was used to calculate pooled "mean differences" (MDs). Study quality was estimated by Newcastle-Ottawa Quality Assessment Scale (NOS) and Cochrane risk of bias (RoB) version 2 tool, and publication bias was estimated through forest plots and the Egger's test.
A total of two randomized controlled trials (RCTs) and five retrospective cohorts were included in this MA. MA results showed that compared with the semaglutide, tirzepatide could produce significantly greater weight loss (MD = 4.23; 95% confidence interval (CI): 3.22 - 5.25; P < 0.01). Subgroup analysis showed a dose- and duration-dependent significantly superior therapeutic effect of tirzepatide (> 10 mg dose: MD = 6.50, 95% CI: 5.93 - 7.08, P < 0.01 vs. ≤ 10 mg: MD = 3.89, 95% CI: 2.12 - 5.65, P < 0.01) (> 6 months duration: MD = 5.00, 95% CI: 3.48 - 6.52, P < 0.01 vs. ≤ 6 months: MD = 3.50, 95% CI: 2.24 - 4.75, P < 0.01). The supremacy of tirzepatide was maintained in both types of studies: RCTs and retrospective cohorts. No publication bias was found through forest plots visually or Egger's test (Egger's regression asymmetry test P value 0.94). Study quality estimated by NOS revealed the quality of each study as "good" (≥ 7 points) and that estimated by the Cochrane RoB tool revealed "low" RoB.
The pooled analysis provides evidence that tirzepatide is better than semaglutide in reducing body weight, regardless of study design. A dose-response relationship exists, and the weight loss magnitude increases with the dose or duration of tirzepatide. The studies that provide this evidence are of high quality and have a low RoB.
本研究的目的是比较替尔泊肽与司美格鲁肽在减重方面的有效性。
于2025年1月22日在PubMed、Scopus和Web of Science数据库中进行系统检索，使用检索词（“替尔泊肽”、“司美格鲁肽”和“减重”）及其替代词，共获得751项研究。去重后，进行标题/摘要和全文筛选，并根据纳入标准对研究进行评估。提取数据后，通过RStudio进行荟萃分析（MA）。使用Cochran's Q和I²检验评估研究间的异质性。采用随机效应模型计算合并“平均差值”（MDs）。通过纽卡斯尔-渥太华质量评估量表（NOS）和Cochrane偏倚风险（RoB）第2版工具评估研究质量，并通过森林图和Egger检验评估发表偏倚。
本荟萃分析共纳入两项随机对照试验（RCT）和五项回顾性队列研究。荟萃分析结果显示，与司美格鲁肽相比，替尔泊肽能显著减轻更多体重（MD = 4.23；95%置信区间（CI）：3.22 - 5.25；P < 0.01））。亚组分析显示，替尔泊肽的治疗效果在剂量和疗程上呈依赖性显著优势（剂量>10 mg：MD = 6.50，95% CI：5.93 - 7.08，P < 0.01；vs. ≤10 mg：MD = 3.89，95% CI：2.12 - 5.65，P < 0.01）（疗程>6个月：MD = 5.00，95% CI：3.48 - 6.52，P < 0.01；vs. ≤6个月：MD = 3.50，95% CI：2.24 - 4.75，P < 0.01）。替尔泊肽在RCT和回顾性队列这两种研究类型中均保持优势。通过森林图直观检查或Egger检验均未发现发表偏倚（Egger回归不对称检验P值为0.94）。NOS评估的研究质量显示每项研究质量为“良好”（≥7分），Cochrane RoB工具评估显示“低”偏倚风险。
汇总分析提供了证据，表明无论研究设计如何，替尔泊肽在减轻体重方面优于司美格鲁肽。存在剂量反应关系，替尔泊肽的减重幅度随剂量或疗程增加。提供此证据的研究质量高且偏倚风险低。
