A large analysis indicates that adults with type 2 diabetes who escalate to 2 mg Ozempic experience better cardiovascular and glycaemic outcomes than those switching to Eli Lilly’s Mounjaro, intensifying competition in the GLP-1 market.
Novo Nordisk said a large real-world analysis of adults with type 2 diabetes found that people who increased their Ozempic dose to 2 mg had better cardiovascular outcomes than those who switched to Eli Lilly’s Mounjaro, adding a fresh dose of competition in the rapidly expanding GLP-1 medicines market.
The Danish drugmaker said the study, called COMPETE SWITCH CV, reviewed treatment patterns among more than 630,000 U.S. adults who used GLP-1 medicines between January 2018 and September 2025. The analysis compared patients who stayed on 1 mg semaglutide, moved up to 2 mg semaglutide, or switched to tirzepatide, the active ingredient in Mounjaro. Novo said about 29% escalated to the higher semaglutide dose within a year, roughly 4% changed to Mounjaro and about 67% remained on the lower dose.
According to Novo Nordisk, follow-up over about two years showed that patients on 2 mg semaglutide had a 6% lower risk of major adverse cardiovascular events than those who switched to tirzepatide, and the difference was statistically significant. The company also said the higher-dose semaglutide group was just as likely to reach an HbA1c level below 7%, a common diabetes control target, and more likely to achieve at least 5% weight loss than patients who switched to tirzepatide.
The study, which Novo said is due to be presented at the European Association for the Study of Diabetes meeting, did not assess safety outcomes. The company’s announcement follows a series of real-world studies on semaglutide and tirzepatide, including earlier analyses in the British Medical Journal group’s Diabetes Research and Clinical Practice and in journals covering oral semaglutide use and comparative effectiveness, underscoring how both manufacturers are leaning heavily on observational data as they compete for market share in diabetes and weight management. Real-world studies can be informative because they reflect routine practice, but they are not the same as randomised clinical trials and can be affected by treatment-selection bias.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
