This record study covered 610,372 UT-Physician patients and about one million sampled from the nationwide COSMOS database. Pharmacy dispensing defined exposure, and weight, lipids, blood pressure and HbA1c were compared before and after each treatment session. Exposure was recorded for 71,318 and roughly one million individuals, and about 70% had two or more sessions. Median exposure to tirzepatide and semaglutide fell far short of the 72-week duration used in trials. After at least 72 weeks on tirzepatide, nearly 50% missed the 10% target and 25% missed the 5% target. Exposure was inferred from dispensing records, so adherence, dose titration and compounded medicines were not captured.
Why it is interesting: Real-world weight loss on GLP-1 and GLP-1/GIP drugs falls well short of trial figures. Exposure was far shorter than trial protocols, and response varied widely at every duration.
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