Tirzepatide versus Semaglutide in the Risk of Cerebral Infarction in Patients with Diagnosis of Type 2 Diabetes Mellitus: A Propensity Score Matching from a Global Federated Health Network Analysis
Mariana Letícia de Bastos Maximiano1, Savio Batista2, Henrique Cian da Cruz3, Henrique Cal4, Diogo Haddad Santos5
1Faculty of Medicine, Fluminense Federal University, 2Emory University, 3Faculty of Medicine, Cesumar University, 4Department of Neurology, Hospital Copa D’Or, Rio de Janeiro, 5Department of Neurology, Santa Casa de São Paulo
Objective:
This study aims to compare the risk of cerebral infarction between patients treated with Tirzepatide and those receiving Semaglutide, leveraging data from a Global Federated Health Network.
Background:
Tirzepatide and Semaglutide are glucagon-like peptide-1 (GLP-1) receptor agonists that have shown promise in managing type 2 diabetes mellitus (T2DM). While these agents improve glycemic control and cardiovascular outcomes, their impact on cerebrovascular events, particularly cerebral infarction, remains under investigation.
Design/Methods:
This observational study utilized anonymized electronic medical records from a global health research network encompassing healthcare organizations worldwide, predominantly in the United States. Patients with T2DM who were prescribed either Tirzepatide or Semaglutide were included. Propensity score matching (PSM) was applied to balance baseline characteristics and comorbidities between the two groups. The primary endpoint was the incidence of cerebral infarction, while the secondary endpoint was mortality.
Results:
A total of 101,980 patients were identified, with 50,990 in the Tirzepatide group and 50,990 in the Semaglutide group after PSM. The mean age was 64.3 ± 11.2 years, with 48.5% being female. During the follow-up period, the risk ratio of cerebral infarction was significantly lower in the Tirzepatide group compared to the semaglutide group (RR 2.02, 95% CI 1.85-2.21). Additionally, Tirzepatide was associated with a lower mortality rate (HR 1.18, 95% CI 1.07-1.29).
Conclusions:
In this extensive real-world analysis, Tirzepatide demonstrated a lower risk of cerebral infarction compared to semaglutide in patients with T2DM. Furthermore, Tirzepatide was associated with reduced mortality. These findings suggest that Tirzepatide may offer superior neurovascular protection compared to Semaglutide, highlighting the need for further clinical trials to confirm these results and explore underlying mechanisms.
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