SURMOUNT-5 Trial: Tirzepatide vs Semaglutide in Obesity Management

Written By :  MDTV Bureau
Published On 2026-04-20 06:17 GMT   |   Update On 2026-04-20 07:19 GMT
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The SURMOUNT-5 trial evaluated the efficacy and safety of tirzepatide compared to semaglutide in adults with obesity or overweight with at least one related complication, but without diabetes. Obesity is now recognized as a chronic, progressive, and relapsing disease, with global prevalence expected to reach 1.9 billion by 2030¹⁻³. While lifestyle interventions such as diet and...

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The SURMOUNT-5 trial evaluated the efficacy and safety of tirzepatide compared to semaglutide in adults with obesity or overweight with at least one related complication, but without diabetes. Obesity is now recognized as a chronic, progressive, and relapsing disease, with global prevalence expected to reach 1.9 billion by 2030¹⁻³. While lifestyle interventions such as diet and exercise remain foundational, they are often insufficient due to biological adaptations⁴⁻⁷, highlighting the need for pharmacological treatments.
SURMOUNT-5 was a 72-week, randomized, open-label Phase 3B trial involving 750 participants. All participants received lifestyle interventions alongside treatment. The primary endpoint was percentage change in body weight at week 72. Results showed that tirzepatide achieved a significantly greater mean weight reduction (21.6%) compared to semaglutide (15.4%)⁸⁻⁹.
Additionally, a higher proportion of patients on tirzepatide achieved weight loss targets of ≥10%, ≥15%, ≥20%, and ≥25%⁹. Notably, 36.2% of patients on tirzepatide achieved ≥25% weight loss versus 19.4% on semaglutide⁹. Tirzepatide also demonstrated superior reduction in waist circumference (20 cm vs 14.7 cm)⁹.

Both treatments showed safety profiles consistent with previous studies, with gastrointestinal events being the most common. Overall, tirzepatide demonstrated superior efficacy in weight reduction and related outcomes compared to semaglutide.

THERAPEUTIC INDICATION¹⁰:

Type 2 diabetes mellitus

Mounjaro®is indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise

• as monotherapy when metformin is considered inappropriate due to intolerance or contraindications

• in addition to other medicinal products for the treatment of diabetes.

Weight management

Mounjaro®is indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance, in adults with an initial Body Mass Index (BMI) of

• ≥ 30 kg/m² (obesity) or

• ≥ 27 kg/m² to < 30 kg/m² (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, prediabetes, or type 2 diabetes mellitus).

For Tirzepatide Prescribing Information, please check: https://image.mc.lilly.com/lib/fe9312747462077971/m/1/0e04e051-5fa2-445b-850d-4f09ef66d35e.pdf

REFERENCES

1. Kelly T, et al. Int J Obes. 2008;(32):1431-1437.

2. NCD Risk Factor Collaboration. Lancet. 2024;403(10431):1027-1050.

3. World Obesity Federation. https://data.worldobesity.org/publications/?cat=23. Accessed July 27, 2025.

4. Apovian CM, et al. J Clin Endocrinol Metab. 2015;100(2):342-362.

5. Hall KD, et al. Med Clin North Am. 2018;102(1):183-197.

6. Fruh SM. J Am Assoc Nurse Pract. 2017;29(S1):S3-S14.

7. Ansari WE, et al. Obes Surg. 2021;31:1755-1766.

8. SURMOUNT-5. ClinicalTrials.gov identifier: NCT05822830. https://clinicaltrials.gov/ct2/show/NCT05822830. Updated December 11, 2024. Accessed February 13, 2025.

9. Aronne LJ, et al. N Engl J Med. 2025;393(1):26-36.

10. Mounjaro®(tirzepatide), India Prescribing Information. Updated March 2025.

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Mounjaro®, KwikPen®and Lilly are registered trademarks of Eli Lilly and Company. To be sold by retail under prescription of Endocrinologist or Internal Medicine Specialists only. For adverse events and safety reporting, please reach out to: mailbox_in-gps@lilly.com. For any additional information related to Lilly products, please reach out to: queries_in-medinfo@lilly.com. For further Information about Lilly and Lilly products please contact us at the below address: Plot 92, Sector 32 Gurgaon, Haryana, 122001 India Ph.: +91-124-4753000/01 | www.lilly.com/in.

CMAT-24202 | 14 April 2026

Eli Lilly and Company. All rights reserved.

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