Something nobody's mentioned — the cardiometabolic secondary endpoints were also meaningfully different:
| Marker | Tirz change | Sema change |
|---|---|---|
| Waist circumference | -17.8 cm | -12.4 cm |
| Triglycerides | -32.4% | -21.6% |
| HDL-C | +8.7% | +4.3% |
| Systolic BP | -7.2 mmHg | -5.1 mmHg |
| hsCRP | -58.3% | -42.1% |
The triglyceride and HDL improvements are really noteworthy and likely GIP-mediated. GIP receptors on adipocytes play a role in lipid storage and mobilization that GLP-1 alone doesn't replicate.
Also the hsCRP reduction suggests a more robust anti-inflammatory effect, which is consistent with the SURMOUNT-OSA and cardiovascular sub-studies.