From:  Synchronizing obesity management with survodutide

 Characteristics of semaglutide, tirzepatide, and survodutide.

CompoundDoses and routes of administrationMechanism of actionClinical efficacyAdverse eventsRef.
SemaglutideOW sc or OD oral; initiated at 0.25 mg OW sc.GLP-1 analogue that delays gastric emptying and promotes hypothalamic satiety signaling.Produces clinically meaningful weight loss, reductions in WC, and improvements in blood pressure, fasting glucose, CRP, lipids, ASCVD outcomes, renal outcomes, MASH resolution, and HRQL.Mainly mild-to-moderate GI events; weight regain may occur after withdrawal.[11]
TirzepatideInitiated at 2.5 mg OW sc.Dual GIP/GLP-1R agonist that reduces appetite and food-related behaviors.In SURMOUNT-5, tirzepatide produced greater reductions in body weight and WC than semaglutide over 72 weeks, with more participants reaching ≥ 10% to ≥ 25% weight-loss thresholds.GI events, usually mild to moderate and concentrated during dose escalation.[13]
SurvodutideDose-escalated to 3.6 mg or 6.0 mg OW sc.Unimolecular GCGR/GLP-1R agonist with an extended half-life.At week 76, body weight decreased by 12.2% with 3.6 mg and 13.0% with 6.0 mg versus 5.4% with placebo; ≥ 5% loss occurred in 72.6%, 71.9% and 46.3%, respectively.Mild-to-moderate GI events occurred in 80.9%, 89.7% and 47.9% of participants receiving 3.6 mg, 6.0 mg and placebo, respectively.[7]
Return to article view

ASCVD: atherosclerotic cardiovascular disease; BMI: body mass index; CRP: C-reactive protein; GCGR: glucagon receptor; GIP: glucose-dependent insulinotropic polypeptide; GLP-1: glucagon-like peptide 1; GLP-1R: glucagon-like peptide 1 receptor; HRQL: health-related quality of life; MASH: metabolic dysfunction-associated steatohepatitis; OD: once daily; OW: once weekly; sc: subcutaneous; WC: waist circumference.