SURMOUNT-5: trial summary, limitations and UK relevance

Key findings

SURMOUNT-5 is the head-to-head trial in adults with obesity comparing tirzepatide directly against semaglutide 2.4 mg (Wegovy) at week 72. Reported greater mean percent body-weight reduction for tirzepatide compared with semaglutide 2.4 mg in the studied population — the first randomised active-comparator evidence for the dual GIP/GLP-1 vs GLP-1 mono-agonist question at the anti-obesity doses of both molecules. This differs from the SURPASS-2 comparison, which used semaglutide at the lower 1.0 mg T2D-licensed dose. SURMOUNT-5 enrolled treatment-naive participants; it does not directly inform mid-treatment switching decisions. Readers should consult the primary publication for exact numerical results before quoting in clinical or editorial contexts.

Safety summary

Both arms showed the expected GI adverse-event class with no novel signals reported in the primary publication.

Limitations

• Single head-to-head trial — broader cross-trial comparison should be done with caution.
• Does not address cardiovascular or other long-term outcomes.

UK relevance

Directly informs UK clinical choice between licensed tirzepatide and licensed semaglutide for weight management in eligible patients.