While a recent head-to-head trial of the obesity med heavyweights Wegovy and Zepbound favored the latter drug from Eli Lilly on weight loss, Novo Nordisk has now countered that result with Zepbound-topping data in another key assessment.
In Novo’s real-world STEER study, Wegovy (semaglutide) at 2.4 mg cut the risk of heart attack, stroke and cardiovascular-related death or death from any cause by 57% in patients without substantial treatment gaps compared to Lilly’s Zepbound (tirzepatide). That translated to 15 recorded cardiovascular events in the study’s Wegovy arm versus 39 reported in the Zepbound cohort, Novo said in an Aug. 31 press release.
In all patients—regardless of any treatment gaps—Wegovy cut the risk of heart attack, stroke and death from any cause by 29% compared to Zepbound, equating to 56 recorded cardiovascular events in the Wegovy group overall versus 83 events recorded among patients on Lilly’s drug, Novo said.
Wegovy and its sister medicine Ozempic already boast approvals to curb cardiovascular risks, while Lilly’s Zepbound does not. That said, Lilly aims to file for approval of tirzepatide to improve cardiovascular outcomes in diabetes patients later this year.
But with data from the STEER study in hand, Novo is arguing that its molecule may boast unique cardio benefits.
"In the STEER study, patients using Wegovy had greater cardiovascular improvements compared to tirzepatide, indicating that the same [cardiovascular] benefit cannot be generalized across other molecules in the GLP-1 or GIP/GLP-1 classes and may come specifically from the semaglutide molecule," Anna Windle, Novo’s SVP of clinical development, medical and regulatory affairs, said in a statement.
The STEER trial compared Wegovy and Zepbound’s ability to lower the risk of major adverse cardiovascular events (MACE) in people who were overweight or obese and who had established cardiovascular disease but not diabetes.
Leveraging a database from Komodo Research, the retrospective, real-world study examined outcomes for U.S. patients who started either Wegovy or Zepbound on or after May 13, 2022. Each treatment group included 10,625 patients, according to Novo.
The main analysis in the study centered on all people who started therapy, regardless of any treatment gaps, while a sensitivity analysis specifically looked at outcomes in people who didn’t have any gaps in their treatment exceeding 30 consecutive days, the company explained.
Novo has good reason to seek an advantage for Wegovy over Zepbound, with the latter drug now leading in terms of branded U.S. obesity sales despite coming to market second, according to executive comments on Lilly’s second-quarter earnings call last month.
That pressure may be even more acutely felt now after Lilly in December unveiled head-to-head trial results demonstrating Zepbound’s apparent weight-loss edge over Wegovy.
In that study, dubbed SURMOUNT-5, Zepbound was 47% more effective than Novo’s Wegovy at helping obesity patients lose weight. Among the 751 patients examined, those on Zepbound lost 20.2% of their weight on average after 72 weeks, compared with 13.7% average weight loss among Wegovy patients.
Although Lilly’s tirzepatide currently lacks a cardiovascular risk reduction nod on either the label for Zepbound in obesity or Mounjaro in diabetes, Lilly is generating heart-helping data all the same.
In late July, the company disclosed results from a head-to-head trial showing that Mounjaro was non-inferior to its earlier GLP-1 Trulicity at reducing cardiovascular death, heart attack or stroke. Lilly plans to file data from its Trulicity head-to-head with global regulators "by the end of this year," the company's science chief, Dan Skovronsky, M.D., Ph.D., said last month.