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Also: Zepbound · LY3298176 · tirz · twincretin
Four separate measurements, never averaged. Independent evidence counts only studies with no sponsor attached. Methodology version v2.0-2026-10 · how we grade evidence
Approved for chronic weight management, for type 2 diabetes, and — in the United States only — for moderate-to-severe obstructive sleep apnoea in adults with obesity, the first drug approved for that condition. Its label was extended in August 2026 to reducing major adverse cardiovascular events in adults with type 2 diabetes at high cardiovascular risk.
It produces the largest weight effect of any agent in the independent network meta-analysis, and the largest lean-mass loss: −8.3% versus lifestyle alone, at moderate certainty. Both findings come from the same analysis and belong together.
One thing the cardiovascular approval does not mean: tirzepatide has never been tested against placebo for cardiovascular outcomes. SURPASS-CVOT compared it with an older Lilly drug and met non-inferiority while missing superiority. That is a safety finding against an active comparator, not a demonstration of cardiovascular benefit.
At a glance
Agonises both the GIP receptor and the GLP-1 receptor. The GLP-1 arm reproduces the appetite suppression, delayed gastric emptying and glucose-dependent insulin secretion of the GLP-1 class, and those effects are confirmed in humans. The GIP contribution is not: whether GIP-receptor agonism, rather than functional antagonism or desensitisation, is what produces the extra weight loss in humans is genuinely unresolved, and the trials were not designed to answer it. The dual-agonist rationale should not be presented as a confirmed human mechanism.
Dated determinations, each flagged for whether it is final and whether it covers safety only. A safety review is not an efficacy finding, and most reporting in this category conflates the two.
Granted on the basis of SURPASS-CVOT, which was an active-comparator non-inferiority trial against dulaglutide that met non-inferiority and missed superiority. Tirzepatide has never been compared with placebo for cardiovascular outcomes.
A United States indication only. In the European Union, obstructive sleep apnoea appears in the product text merely as a qualifying comorbidity for weight management, not as a standalone indication.
Mounjaro was approved for type 2 diabetes on 13 May 2022; Zepbound for chronic weight management on 8 November 2023, in adults with obesity or overweight plus at least one weight-related condition.
CHMP opinion 21 July 2022, authorised 15 September 2022. Indications now cover type 2 diabetes in adults and children aged 10 and over, and weight management in adults. Marketing authorisation holder Eli Lilly Nederland B.V.
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