Ozempic 2 mg Linked to Lower Risk of Major Cardiovascular Events Compared with Switching to Mounjaro
Dubai(News Desk):: Novo Nordisk has announced new real-world evidence suggesting that adults with type 2 diabetes who increased their dose of once-weekly semaglutide from 1 mg to 2 mg had a statistically significant lower risk of major adverse cardiovascular events (MACE) compared with those who switched to tirzepatide, the active ingredient in Mounjaro.
The findings were presented at the European Association for the Study of Diabetes (EASD) Annual Meeting 2026 in Milan, Italy.
The retrospective real-world analysis included 636,525 adults with type 2 diabetes who were receiving semaglutide 1 mg. Within 365 days of starting the treatment, 29.2% of patients had increased their dose to semaglutide 2 mg, while 3.6% had switched to tirzepatide.
According to the analysis, patients who escalated to semaglutide 2 mg experienced a 6% lower risk of major adverse cardiovascular events compared with those who switched to tirzepatide doses of up to 15 mg. MACE in the analysis included all-cause death, myocardial infarction (heart attack), and stroke.
The analysis reported an adjusted hazard ratio of 1.06 (95% CI 1.04–1.08; P=0.005) for the comparison.
At 720 days of follow-up, 57.4% of patients remained on semaglutide 1 mg, while 36.9% had escalated to semaglutide 2 mg and 5.7% had switched to tirzepatide. Among patients who switched to tirzepatide, physicians could subsequently adjust the dose according to the treatment regimen, with approximately 31% reaching doses of 10 mg or higher during follow-up.
A separate analysis of a subset of patients with more than one HbA1c and/or weight measurement at baseline produced consistent findings, with an adjusted hazard ratio of 1.07 (95% CI 1.01–1.13; P<0.035).
Michael Radin, MD, Executive Medical Director at Novo, said treatment adjustments are often necessary for people with type 2 diabetes seeking better glycemic control, while cardiovascular risk also remains an important consideration.
“These real-world findings can help provide insights into how intensification strategies may affect cardiovascular outcomes as an important factor in patient care,” Radin said.
Kathryn S. Tierney, MSN, APRN, FNP-BC, FAANP, of Middlesex Health MultiSpecialty Group in Middletown, Connecticut, said treatment intensification is a common challenge in clinical practice, particularly among patients who have not yet reached their treatment goals but are tolerating their existing regimen.
The new findings build on an earlier analysis of the same data that examined changes in HbA1c and body weight.
Researchers emphasized that real-world retrospective analyses have important limitations. Such studies can be affected by residual and unmeasured confounding and can demonstrate associations without establishing a definitive causal relationship. Claims-based data may also exclude people with intermittent insurance coverage or underserved populations, which may limit how broadly the findings can be applied.
The analysis did not assess safety outcomes.
Novo Nordisk also noted that semaglutide injection carries a Boxed Warning concerning the potential risk of thyroid tumors, including thyroid cancer. The medicine should not be used by people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
The most common side effects reported with semaglutide include nausea, vomiting, diarrhea, abdominal pain and constipation.
