Novo Nordisk announced new real-world evidence in adults with type 2 diabetes (T2D) treated with once-weekly semaglutide 1 mg that examines how escalating to semaglutide 2 mg compares with switching to tirzepatide and supports patient goals for HbA1c and weight loss. By one year, both groups were associated with similar proportions of patients achieving an HbA1c of less than 7%. For blood glucose outcomes, results from the cohort of more than 64,000 adults living with T2D (escalated to semaglutide 2 mg, n=55,550; switched to tirzepatide, n=9,338; baseline HbA1c: 7.2%) showed comparable rates of patients reaching an HbA1c less than 7%.

In a cohort of more than 56,000 adults living with T2D (escalated to semaglutide 2 mg, n=48,596; switched to tirzepatide, n=8,256), the analysis found that people on semaglutide 2 mg had a higher event rate for achieving weight loss greater than or equal to 5% compared to people switching to tirzepatide (starting at 2.5 mg or 5 mg with ability to titrate), from a baseline of 105 kg and 106.2 kg, respectively. By one year, 60.5% (95% CI: 58.7%?62.3%) of adults who escalated to semaglutide 2 mg achieved greater than or equal to 5% weight loss compared with 55.3% (53.9%?56.7%) who switched to tirzepatide. Most patients who switched to tirzepatide started at 5 mg and approximately 3%?5% reached tirzepatide 15 mg.

Real-world study data can provide valuable insights into how treatments work outside of controlled clinical trial settings. Real-world data analyses also have several limitations; results may reflect residual unmeasured confounding, while associations can be demonstrated, causal relationships cannot be definitively established. Additionally, use of retrospective claims data may exclude patients with intermittent coverage or underserved populations, potentially limiting generalizability.

COMPETE SWITCH is a retrospective cohort study using Komodo Health's Healthcare Map with linked laboratory results, a large US healthcare claims database (January 2018? September 2025), which evaluated the dosing and titration of semaglutide and tirzepatide in a real-world setting. Patients included were adults with type 2 diabetes with a prescription claim for semaglutide 1 mg with subsequent claims for either semaglutide 2 mg or tirzepatide 2.5 mg or 5 mg.

The study included 64,888 adults in an HbA1c cohort and 56,852 in a weight-loss cohort. As with all observational analyses, the findings have inherent limitations and may not fully translate to all clinical settings. While many patients have HbA1c and weight information, not all do, limiting the ability to characterize those patients who do not.

Additional limitations exist in the ability to characterize or describe social determinants that may impact medication adherence or influence switching. There is no reason to suspect these differences will differentially bias the results.