Dual incretin analogue tirzepitide - SURMOUNTing the challenge of obesity induced obstructive sleep apnea

Table 2 Comparison of the two major parenteral incretin analogues - semaglutide and tirzepatide

Parameters	Semaglutide	Tirzepatide
Drug class	GLP-1 receptor agonist	Dual GIP and GLP-1 receptor agonist (twincretin)
Mechanism of action	Mimics GLP-1: Suppresses appetite, slows gastric emptying, regulates insulin and glucagon	Activates both GIP and GLP-1 receptors: Synergistically reduces appetite, enhances insulin sensitivity
Receptor targets	GLP-1 only	GLP-1 and GIP
Dosing frequency	Once weekly (subcutaneous)	Once weekly (subcutaneous)
FDA approval for obesity	Approved (as Wegovy)	Approved for Obesity/OSA (as Zepbound)
Additional benefits	Cardiovascular risk reduction	Potentially better metabolic and cardiovascular profile
Effect on appetite	Reduces appetite via central GLP-1 pathways	Stronger appetite suppression via dual hormone action
Effect on gastric emptying	Slows gastric emptying	Slows gastric emptying
Insulin sensitivity	Improves glucose-dependent insulin secretion	Further improves insulin sensitivity through GIP action
Weight loss efficacy	High (average about 10%-15% body weight reduction)	Higher (average about 15%-22% body weight reduction)

GLP: Glucagon like peeptide; GIP: Glucose dependent insulinotropic polypeptide.