Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026)

Waqar Ahmed Khan; Atyesha Elahi

doi:10.5455/JMRR.20260526050512

Original Article
Online Published: 03 Aug 2026

J Med Res Rev. 2026; 5(3): 159-167

doi: 10.5455/JMRR.20260526050512

Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026)

Waqar Ahmed Khan, Atyesha Elahi.

Abstract
Background and aims: While GLP-1 and dual GIP/GLP-1 receptor agonists are proven in trials, their real-world application in the Middle East requires scrutiny. This systematic review and meta-analysis compares the real-world effectiveness and treatment persistence of Tirzepatide versus Semaglutide in Middle Eastern populations.
Methods: Following PRISMA guidelines (PROSPERO: CRD42026019344), we searched PubMed, Embase, and the Saudi Digital Library for real-world studies published between 2020 and February 2026. Studies were included if they reported HbA1c or weight loss outcomes in adults with T2DM or obesity strictly within the MENA region.
Results: Seven studies (n=12,450) were synthesized. In the Middle Eastern subgroup, Tirzepatide demonstrated a superior weight loss of 15.5% to 22.0% compared to 10.3% to 11.6% for Semaglutide (p < 0.001). However, the 6-month discontinuation rate reached 56.3%, significantly higher than clinical trial benchmarks.
Conclusions: Tirzepatide offers enhanced clinical efficacy in MENA populations; however, high discontinuation rates—driven by localized supply chain disruptions and titration challenges during fasting periods—require tailored clinical protocols to maintain long-term metabolic outcomes.

Key words: Tirzepatide; Semaglutide; Metabolic syndrome; Treatment persistence; Middle East; Systematic review

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How to Cite this Article

Pubmed Style

Khan WA, Elahi A. Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). J Med Res Rev. 2026; 5(3): 159-167. doi:10.5455/JMRR.20260526050512

Web Style

Khan WA, Elahi A. Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). https://www.wisdomgale.com/jmrr/?mno=322330 [Access: August 06, 2026]. doi:10.5455/JMRR.20260526050512

AMA (American Medical Association) Style

Khan WA, Elahi A. Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). J Med Res Rev. 2026; 5(3): 159-167. doi:10.5455/JMRR.20260526050512

Vancouver/ICMJE Style

Khan WA, Elahi A. Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). J Med Res Rev. (2026), [cited August 06, 2026]; 5(3): 159-167. doi:10.5455/JMRR.20260526050512

Harvard Style

Khan, W. A. & Elahi, . A. (2026) Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). J Med Res Rev, 5 (3), 159-167. doi:10.5455/JMRR.20260526050512

Turabian Style

Khan, Waqar Ahmed, and Atyesha Elahi. 2026. Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). Journal of Medical Research and Reviews, 5 (3), 159-167. doi:10.5455/JMRR.20260526050512

Chicago Style

Khan, Waqar Ahmed, and Atyesha Elahi. "Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026)." Journal of Medical Research and Reviews 5 (2026), 159-167. doi:10.5455/JMRR.20260526050512

MLA (The Modern Language Association) Style

Khan, Waqar Ahmed, and Atyesha Elahi. "Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026)." Journal of Medical Research and Reviews 5.3 (2026), 159-167. Print. doi:10.5455/JMRR.20260526050512

APA (American Psychological Association) Style

Khan, W. A. & Elahi, . A. (2026) Real-World Comparative Effectiveness and Treatment Persistence of Tirzepatide versus Semaglutide in Middle Eastern Populations: A Systematic Review and Meta-Analysis (2020–2026). Journal of Medical Research and Reviews, 5 (3), 159-167. doi:10.5455/JMRR.20260526050512