Bayesian network meta-analysis compares tirzepatide, liraglutide, and semaglutide for weight reduction in adults without diabetes

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Advances in therapy Published May 8, 2026 Medically reviewed May 8, 2026 Study authors: Ciudin Andreea, Sapin Helene, Fan Ludi, Dimitriadis Georgios K, Zimner-Rapuch Sarah, Curteis Tristan… PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that this network meta-analysis reports associations, not causality, for greater weight reduction with tirzepatide versus liraglutide and semaglutide.

This is a Bayesian network meta-analysis that synthesized evidence from a systematic literature review of 42 randomized controlled trials, with six trials included in the final network. The scope was to compare the efficacy of tirzepatide (5, 10, and 15 mg) against liraglutide (3 mg) and semaglutide (2.4 mg) for weight reduction outcomes in adults without type 2 diabetes who have obesity or overweight with at least one obesity-related complication.

The authors found that tirzepatide 10 mg and 15 mg showed statistically greater percentage weight reduction versus liraglutide, with effect sizes of -12.86% and -13.95% respectively. Versus semaglutide, tirzepatide 10 mg and 15 mg also showed statistically greater improvements, with effect sizes of -4.85% and -6.26% respectively. For waist circumference, tirzepatide 10 mg and 15 mg demonstrated statistically greater reductions versus liraglutide (-11.79 cm and -12.30 cm) and versus semaglutide (-4.81 cm and -5.32 cm).

Improvements in triglycerides and diastolic blood pressure were statistically greater with tirzepatide versus liraglutide. For other glycaemic, lipid, and blood pressure parameters, improvements were generally comparable between tirzepatide and both comparators. The authors noted a stringent heterogeneity assessment as a limitation.

The analysis did not report adverse events, serious adverse events, or discontinuations, but noted that all interventions had a comparable safety profile. The authors emphasize that the network meta-analysis reports associations and does not support causal inferences. Practice relevance is restrained given the limited number of trials in the network and the lack of reported safety data.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID41820778

View Original Abstract ↓

INTRODUCTION: Recent pharmacological options for weight management include the glucagon-like peptide 1 (GLP-1) receptor agonists semaglutide and liraglutide, and the glucose-dependent insulinotropic polypeptide and GLP-1 receptor agonist tirzepatide, but head-to-head comparisons of all three of these interventions are lacking. METHODS: Based on a systematic literature review (SLR) and Bayesian network meta-analysis (NMA), the efficacy and safety of semaglutide 2.4 mg, liraglutide 3 mg and tirzepatide 5, 10 and 15 mg were compared in adults without type 2 diabetes, and with either obesity (body mass index [BMI] ≥ 30 kg/m) or overweight (BMI ≥ 27 kg/m) with ≥ 1 obesity-related complication. RESULTS: Following a stringent heterogeneity assessment, six of 42 randomised controlled trials identified in the SLR were included in the NMA. Efficacy estimand results showed all tirzepatide doses were associated with statistically greater improvements in weight reduction outcomes versus liraglutide, and for tirzepatide 10 and 15 mg versus semaglutide: including percentage weight reduction (- 12.86% for tirzepatide 10 mg and - 13.95% for tirzepatide 15 mg versus liraglutide; - 4.85% and - 6.26% versus semaglutide) and waist circumference (- 11.79 cm and - 12.30 cm versus liraglutide; - 4.81 cm and - 5.32 cm versus semaglutide). All tirzepatide doses were associated with statistically greater improvements in triglycerides and diastolic blood pressure versus liraglutide, and generally comparable improvements in other glycaemic, lipid and blood pressure parameters versus liraglutide and semaglutide. All interventions had a comparable safety profile. CONCLUSION: In this NMA, tirzepatide 10 and 15 mg were associated with improved efficacy versus liraglutide, improved or comparable efficacy versus semaglutide, and all interventions had a generally comparable safety profile for achieving weight reduction and reducing cardiometabolic risk factors among patients with obesity or overweight.