Novo Nordisk recently presented data from the STEER real-world study of evidence gathered from actual patient experiences at the European Society of Cardiology (ESC) Congress 2025 in Madrid, Spain. The STEER study investigated the risk of Major Adverse Cardiovascular Events (MACE) with Semaglutide 2.4 mg compared with Tirzepatide treatment in people with overweight or obesity, and established CVD without diabetes.

Compared with Tirzepatide, Semaglutide 2.4 mg showed a significant 57 percent greater risk reduction for heart attack, stroke and cardiovascular-related death or death from any cause, in people with overweight or obesity and CVD, who did not have any gaps in their treatment lasting more than 30 days. There were 15 (0.1 percent) of these cardiovascular events recorded with Semaglutide 2.4 mg and 39 events (0.4 percent) were recorded with Tirzepatide. The average follow-up duration was 3.8 months for the Semaglutide 2.4 mg group and 4.3 months for the Tirzepatide group.

In all treated people, regardless of any gaps in their treatment, Semaglutide 2.4 mg showed a significant 29 percent risk reduction for heart attack, stroke and death from any cause compared with Tirzepatide (over an average follow-up of 8.3 months for Semaglutide 2.4 mg and 8.6 months for Tirzepatide).

Ludovic Helfgott, Executive Vice President (EVP) and Head of Product and Portfolio Strategy, Novo Nordisk, said, “Our landmark trial, SELECT, showed that Semaglutide 2.4 mg is associated with a significant 20 percent risk reduction of cardiovascular events, backed up with even greater risk reductions in the real-world studies SCORE and STEER. The results are clear–STEER demonstrates that Semaglutide 2.4 mg cuts the risk of heart attack, stroke or death by 57 percent compared to Tirzepatide. This data confirms that Semaglutide stands apart as the only available GLP-1-based medication with proven cardiovascular benefits for people living with obesity and cardiovascular disease, without diabetes.”

Every year, almost 21 million people die from CVD, which is the leading cause of disability and death worldwide. Obesity directly leads to cardiovascular morbidity, mortality and hospitalisation. While cardiovascular mortality has decreased over the past two decades, obesity-related cardiovascular deaths have increased significantly, with two in three obesity-related deaths being linked to CVD.

Dr Ashwani Mehta, Senior Consultant Cardiologist, Professor, GRIPMER, Director—Heart Failure Programme and Research, Sir Ganga Ram Hospital, New Delhi, said, "The STEER study provides important information about how weight-loss treatments affect heart health. It was found that people using Semaglutide 2.4 mg had significantly lesser risk of cardiovascular events compared to those using Tirzepatide. This is a major development for individuals dealing with obesity and heart disease, suggesting that Semaglutide 2.4 mg can help with weight loss and also potentially save lives. Studies like STEER are important because they show how these treatments work in real life, outside of strict clinical trials, making the results more relevant for everyday care. This research is a key step in improving heart health and weight management approaches."

Real-world studies of evidence gathered from actual patient experiences can complement randomised control trials, which are the gold standard for evaluating the safety and efficacy of a treatment. STEER was a retrospective, observational real-world study, evaluating the efficacy of Semaglutide 2.4 mg versus Tirzepatide for the prevention of MACE in US adults with overweight or obesity and established CVD with no prior history of diabetes, with a primary outcome measure of revised five-point MACE (heart attack, stroke, hospitalisation for heart failure, coronary revascularisation and death from any cause) and revised three-point MACE (heart attack, stroke and death from any cause). Non-revised five-point and three-point MACE was also studied, which included cardiovascular-related death rather than death from any cause.

Dr Prakash Sanzgiri, MD, DM—Consultant, Critical Care and Interventional Cardiologist, Mumbai, said, “The real-world data presented in the STEER study adds significant value, as it extends beyond controlled trials to provide evidence-based findings. The results clearly indicate that Semaglutide 2.4 mg is superior to Tirzepatide in reducing cardiovascular events in individuals with overweight or obesity. Specifically, Semaglutide 2.4 mg has demonstrated a much lower risk of serious heart issues, including heart attacks and strokes. For patients struggling with both weight management and cardiovascular concerns, these findings pave the way for a more comprehensive and effective approach to patient care.”

The study included people from the US Komodo Research database (1 January, 2016 to 31 January, 2025) aged ≥45 years and started treatment with Semaglutide 2.4 mg or Tirzepatide on or after 13 May, 2022. Each treatment group comprised 10,625 people. To ensure both groups were comparable, researchers used propensity score matching to compare Semaglutide 2.4 mg users and Tirzepatide users with similar characteristics. After matching, characteristics were well-balanced between the treatment groups.