Tirzepatide as a novel effective and safe strategy for treating obesity: a systematic review and meta-analysis of randomized controlled trials.

Cai W, Zhang R, Yao Y, Wu Q, Zhang J

Frontiers in public health31 Jan 2024Cited by 38 (Europe PMC)

PMID38356942PMCIDPMC10864442DOI10.3389/fpubh.2024.1277113PepBankPUB-38356942

Summary

ObjectiveTo systematically evaluate the efficacy and safety of a new hypoglycemic drug, tirzepatide, for treating obesity based on indicators such as BMI, waist circumference, and body weight.MethodsA search formula was written using search terms such as "tirzepatide," "overweight," and "obesity." A comprehensive search was conducted on databases such as PubMed, Cochrane Library, Embase, and Web of Science using a computer. Random controlled trial (RCT) literature was selected based on inclusion and exclusion criteria. After extracting the data, literature bias risk assessment and meta-analysis were conducted using RevMan 5.4 software. The search deadline is from the establishment of each database to May 2023.ResultsA total of 12 randomized controlled trials were included, with a total of 11,758 patients. Meta analysis results showed that compared with the glucagon like peptide-1 receptor agonist (GLP-1 RAs), placebo and insulin groups, tirzepatide could significantly reduce the BMI (body mass index) of patients [MD = -1.71, 95% CI (-2.46, -0.95), p p p < 00.00001]. In terms of decreasing waist circumference, tirzepatide has a more significant advantage [MD = -4.08, 95% CI (-5.77, -2.39), p p p < 0.00001]. In the analysis of body weight, tirzepatide showed a more significant reduction effect compared to the control group [MD = -5.65, 95% CI (-7.47, -3.82), p p p < 0.001]. In comparison with placebo, tirzepatide had a prominent advantage in weight loss ≥20% and ≥25% [RR = 30.43, 95% CI (19.56, 47.33), p p < 0.00001]. Subgroup analysis showed a dose-dependent therapeutic effect. In terms of safety, compared with the placebo and insulin groups, the incidence of gastrointestinal adverse reactions was markedly higher in the tirzepatide group, slightly higher to the GLP-1 RAs group. The hypoglycemic (p < 0.001]. The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p > 0.05).ConclusionTirzepatide, as a weight loss drug, significantly reduces BMI, waist circumference and body weight while gastrointestinal adverse reactions need to be vigilant. Overall, its efficacy is significant and its safety is high.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study17

17 results from studies that gave the peptide. 17 results from people.

01HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide reduced BMI more than GLP-1 receptor agonists.
In plain wordsIn adults with overweight or obesity, tirzepatide lowered BMI more than GLP-1 drugs did.
Peptide
Tirzepatide
Outcome
DecreaseBMI versus GLP-1 RAs
Study
n: not reported in source
Comparator
GLP-1 receptor agonists
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
MD
−1.71 kg/m2
vs GLP-1 RAs
Source sentences
Summary
Meta analysis results showed that compared with the glucagon like peptide-1 receptor agonist (GLP-1 RAs), placebo and insulin groups, tirzepatide could significantly reduce the BMI (body mass index) of patients [MD = -1.71, 95% CI (-2.46, -0.95), p p p < 00.00001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694201
02HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide reduced BMI more than placebo.
In plain wordsIn adults with overweight or obesity, tirzepatide lowered BMI more than placebo.
Peptide
Tirzepatide
Outcome
DecreaseBMI versus placebo
Study
n: not reported in source
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
MD
−3.99 kg/m2
vs placebo
Source sentences
Summary
Meta analysis results showed that compared with the glucagon like peptide-1 receptor agonist (GLP-1 RAs), placebo and insulin groups, tirzepatide could significantly reduce the BMI (body mass index) of patients [MD = -1.71, 95% CI (-2.46, -0.95), p p p < 00.00001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694202
03HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide reduced BMI more than insulin.
In plain wordsIn adults with overweight or obesity, tirzepatide lowered BMI more than insulin.
Peptide
Tirzepatide
Outcome
DecreaseBMI versus insulin
Study
n: not reported in source
Comparator
Insulin
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
MD
−4.02 kg/m2
vs insulin
Source sentences
Summary
Meta analysis results showed that compared with the glucagon like peptide-1 receptor agonist (GLP-1 RAs), placebo and insulin groups, tirzepatide could significantly reduce the BMI (body mass index) of patients [MD = -1.71, 95% CI (-2.46, -0.95), p p p < 00.00001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694203
04HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide reduced waist circumference more than control groups.
In plain wordsIn adults with overweight or obesity, tirzepatide reduced waist size more than control treatments.
Peptide
Tirzepatide
Outcome
DecreaseWaist circumference
Study
n: not reported in source
Comparator
Control groups
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
MD
−4.08 unit not stated
comparison 1
MD
−7.71 unit not stated
comparison 2
MD
−9.15 unit not stated
comparison 3
Source sentences
Summary
In terms of decreasing waist circumference, tirzepatide has a more significant advantage [MD = -4.08, 95% CI (-5.77, -2.39), p p p < 0.00001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694204
05HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide reduced body weight more than control groups.
In plain wordsIn adults with overweight or obesity, tirzepatide led to more weight loss than control treatments.
Peptide
Tirzepatide
Outcome
DecreaseBody weight
Study
n: not reported in source
Comparator
Control groups
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
MD
−5.65 unit not stated
comparison 1
MD
−10.06 unit not stated
comparison 2
MD
−10.63 unit not stated
comparison 3
Source sentences
Summary
In the analysis of body weight, tirzepatide showed a more significant reduction effect compared to the control group [MD = -5.65, 95% CI (-7.47, -3.82), p p p < 0.001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694205
06HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide gave a higher proportion with weight loss of 20% or more than placebo.
In plain wordsIn adults with overweight or obesity, many more people lost at least 20% of their weight on tirzepatide than on placebo.
Peptide
Tirzepatide
Outcome
IncreaseWeight loss of 20% or more
Study
n: not reported in source
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
RR
30.43 ratio
weight loss >=20%
Source sentences
Summary
In comparison with placebo, tirzepatide had a prominent advantage in weight loss ≥20% and ≥25% [RR = 30.43, 95% CI (19.56, 47.33), p p < 0.00001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694206
07HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide gave a higher proportion with weight loss of 25% or more than placebo.
In plain wordsIn adults with overweight or obesity, many more people lost at least 25% of their weight on tirzepatide than on placebo.
Peptide
Tirzepatide
Outcome
IncreaseWeight loss of 25% or more
Study
n: not reported in source
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Measurements
RR
37.25 ratio
weight loss >=25%
Source sentences
Summary
In comparison with placebo, tirzepatide had a prominent advantage in weight loss ≥20% and ≥25% [RR = 30.43, 95% CI (19.56, 47.33), p p < 0.00001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694207
08HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, subgroup analysis showed a dose-dependent therapeutic effect of tirzepatide.
In plain wordsIn adults with overweight or obesity, higher tirzepatide doses had a larger effect in subgroup analysis.
Peptide
Tirzepatide
Outcome
Not applicableDose-dependence of efficacy
Study
n: not reported in source
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Subgroup analysis showed a dose-dependent therapeutic effect.
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694208
09HumanSystematic reviewSafety outcome
In adults with overweight or obesity, gastrointestinal adverse reactions were markedly more frequent with tirzepatide than with placebo or insulin.
In plain wordsIn adults with overweight or obesity, stomach and gut side effects were clearly more common with tirzepatide than with placebo or insulin.
Peptide
Tirzepatide
Outcome
IncreaseGastrointestinal adverse reactions versus placebo and insulin
Study
n: not reported in source
Comparator
Placebo and insulin
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
Dose not stated
Source sentences
Summary
In terms of safety, compared with the placebo and insulin groups, the incidence of gastrointestinal adverse reactions was markedly higher in the tirzepatide group, slightly higher to the GLP-1 RAs group.
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694209
10HumanSystematic reviewSafety outcome
In adults with overweight or obesity, gastrointestinal adverse reactions were slightly more frequent with tirzepatide than with GLP-1 receptor agonists.
In plain wordsIn adults with overweight or obesity, stomach and gut side effects were slightly more common with tirzepatide than with GLP-1 drugs.
Peptide
Tirzepatide
Outcome
IncreaseGastrointestinal adverse reactions versus GLP-1 RAs
Study
n: not reported in source
Comparator
GLP-1 receptor agonists
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
Dose not stated
Source sentences
Summary
In terms of safety, compared with the placebo and insulin groups, the incidence of gastrointestinal adverse reactions was markedly higher in the tirzepatide group, slightly higher to the GLP-1 RAs group.
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694210
11HumanSystematic reviewSafety outcome
In adults with overweight or obesity, tirzepatide carried a significantly lower risk of hypoglycemia than insulin.
In plain wordsIn adults with overweight or obesity, tirzepatide caused low blood sugar less often than insulin.
Peptide
Tirzepatide
Outcome
DecreaseHypoglycemia (<70 mg/dL) versus insulin
Study
n: not reported in source
Comparator
Insulin
Outcome group
Adverse events · Metabolic and weight
Studied dose
Dose not stated
Measurements
RR
0.46 ratio
vs insulin
Source sentences
Summary
The hypoglycemic (p < 0.001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694211
12HumanSystematic reviewSafety outcome
In adults with overweight or obesity, the hypoglycemia risk with tirzepatide was slightly higher than with placebo and GLP-1 receptor agonists.
In plain wordsIn adults with overweight or obesity, low blood sugar was slightly more common with tirzepatide than with placebo or GLP-1 drugs.
Peptide
Tirzepatide
Outcome
IncreaseHypoglycemia (<70 mg/dL) versus placebo and GLP-1 RAs
Study
n: not reported in source
Comparator
Placebo and GLP-1 receptor agonists
Outcome group
Adverse events · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
The hypoglycemic (p < 0.001].
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694212
13HumanSystematic reviewSafety outcome
In adults with overweight or obesity, pancreatitis incidence with tirzepatide did not differ significantly from controls.
In plain wordsIn adults with overweight or obesity, pancreatitis was not significantly more common with tirzepatide than in the control group.
Peptide
Tirzepatide
Outcome
No significant changePancreatitis
Study
n: not reported in source
Comparator
Control group
Outcome group
Adverse events · Gastrointestinal
Studied dose
Dose not stated
Source sentences
Summary
The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p > 0.05).
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694213
14HumanSystematic reviewSafety outcome
In adults with overweight or obesity, cholecystitis incidence with tirzepatide did not differ significantly from controls.
In plain wordsIn adults with overweight or obesity, gallbladder inflammation was not significantly more common with tirzepatide than in the control group.
Peptide
Tirzepatide
Outcome
No significant changeCholecystitis
Study
n: not reported in source
Comparator
Control group
Outcome group
Adverse events · Gastrointestinal
Studied dose
Dose not stated
Source sentences
Summary
The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p > 0.05).
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694214
15HumanSystematic reviewSafety outcome
In adults with overweight or obesity, MACE-4 incidence with tirzepatide did not differ significantly from controls.
In plain wordsIn adults with overweight or obesity, major heart events were not significantly more common with tirzepatide than in the control group.
Peptide
Tirzepatide
Outcome
No significant changeMajor adverse cardiovascular events-4
Study
n: not reported in source
Comparator
Control group
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p > 0.05).
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694215
16HumanSystematic reviewSafety outcome
In adults with overweight or obesity, hypersensitivity reaction incidence with tirzepatide did not differ significantly from controls.
In plain wordsIn adults with overweight or obesity, allergic-type reactions were not significantly more common with tirzepatide than in the control group.
Peptide
Tirzepatide
Outcome
No significant changeHypersensitivity reactions
Study
n: not reported in source
Comparator
Control group
Outcome group
Adverse events · Immune and inflammation
Studied dose
Dose not stated
Source sentences
Summary
The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p > 0.05).
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694216
17HumanSystematic reviewSafety outcome
In adults with overweight or obesity, neoplasm incidence with tirzepatide did not differ significantly from controls.
In plain wordsIn adults with overweight or obesity, new tumors were not significantly more common with tirzepatide than in the control group.
Peptide
Tirzepatide
Outcome
No significant changeNeoplasms
Study
n: not reported in source
Comparator
Control group
Outcome group
Adverse events · Cancer
Studied dose
Dose not stated
Source sentences
Summary
The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p > 0.05).
1 context sentence(design, population, supporting numbers)
Summary · context
A total of 12 randomized controlled trials were included, with a total of 11,758 patients.
Show in the study text Report a problemFND-3835694217

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Version history

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Version 2Current
9 Oct 2026, 19:08 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC

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Terms as the source lists them.

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Keywords

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