Expert Consensus Outlines Safety Management and Personalized Use of Semaglutide and Tirzepatide for Obesity

Obesity is a complex chronic disease with significant health implications, often requiring long-term pharmacological intervention. Incretin-based therapies, specifically GLP-1 and GIP receptor agonists like semaglutide and tirzepatide, have demonstrated substantial efficacy in weight management. However, as these powerful agents become more widely adopted, understanding their optimal safety profile and personalized application in diverse patient populations is crucial. This consensus addresses the need for clear guidance on managing potential adverse events and tailoring treatment strategies.

On December 3, 2025, an expert working group convened in Moscow to discuss the safety and personalized application of tirzepatide (Tirzetta®) and semaglutide (Velgia® eco) for patients with overweight and obesity. The group comprised specialists in endocrinology, cardiology, and gastroenterology. Following extensive discussion and review of existing clinical data and real-world experience, a consensus position was developed to guide the optimal use of these incretin receptor agonists in clinical practice.

The expert working group developed a comprehensive consensus position outlining best practices for the safe and personalized use of semaglutide and tirzepatide in patients with overweight and obesity. While the abstract does not provide specific numerical findings or statistical data from a primary study, the consensus focuses on practical clinical recommendations. These recommendations encompass optimal patient selection criteria, strategies for dose titration to minimize adverse effects, and guidance on managing common side effects, particularly gastrointestinal issues. The consensus also addresses considerations for patients with various comorbidities and emphasizes the importance of individualized treatment plans. It aims to standardize approaches to monitoring, follow-up, and long-term management, providing clinicians with a structured guide for maximizing the benefits of incretin-based therapies while mitigating risks.