Semaglutide Shows Greater CVD Risk Reduction Than Tirzepatide in Adults With Obesity: Daily Dose

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On September 2, 2025, we reported on data from the STEER real-world study of adults with obesity and established cardiovascular disease (CVD) but without diabetes presented at the European Society of Cardiology (ESC) Congress 2025.

The study

The STEER study analyzed data from the Komodo Research database, including US adults aged ≥45 years with overweight or obesity and CVD who initiated semaglutide or tirzepatide between May 2022 and January 2025. Each treatment cohort included 10 625 participants matched for baseline characteristics. The primary outcome was incidence of major adverse cardiovascular events (MACE), defined as heart attack, stroke, hospitalization for heart failure, coronary revascularization, or death.

The findings

In a sensitivity analysis of patients without treatment interruptions longer than 30 days, MACE occurred in 0.1% of semaglutide users compared with 0.4% of tirzepatide users, corresponding to a 57% relative risk reduction. In the full cohort, including those with treatment gaps, semaglutide was associated with a 29% lower risk of MACE compared with tirzepatide after an average follow-up of approximately 8 months.

Investigators noted these findings complement results from the randomized SELECT trial, which showed a 20% reduction in cardiovascular events with semaglutide compared with placebo, and the SCORE real-world study, which also demonstrated lower cardiovascular event rates among semaglutide users.

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