Biomeme
Comparative Evidence

GLP-1 Drug Evidence Scorecard.

How do major GLP-1 medications compare on published clinical trial evidence and molecular pathway characterization? We evaluate each drug across five published dimensions.

Evidence Evaluation Methodology

Each drug is evaluated across 5 dimensions (20 points each, 100 total) using published clinical trial data and transcriptomic pathway characterization. This scorecard reflects published clinical literature, not individual patient response predictions.

Transcriptomic Evidence (20): how thoroughly the molecule's effects on gene expression have been characterized in published human transcriptomic studies. Scored per molecule, so brands that share a molecule share a score.

Weight Loss Efficacy (20): mean percent body-weight change at the highest labeled dose in the brand's pivotal trial, in the brand's labeled population, using the treatment-policy (treatment-regimen) estimand. ≥20% = 20; 14–19.9% = 16; 10–13.9% = 14; 7–9.9% = 12; 5–6.9% = 10; 3–4.9% = 8; under 3% = 6.

Tolerability (20): discontinuation because of adverse reactions at the highest labeled dose, from the U.S. prescribing information and pivotal trials.

CV Evidence (20): 19 = a placebo-controlled trial designed for superiority met its major adverse cardiovascular event (MACE) endpoint and the label carries a MACE indication; 18 = MACE indication from a noninferiority-designed trial, plus a second positive outcome trial; 17 = MACE indication from a single noninferiority-designed trial that also showed superiority; 16 = MACE indication from noninferiority to an active comparator with proven cardiovascular benefit; 15 = a positive placebo-controlled heart-failure outcome trial, no MACE indication; 14 = no outcome trial at the labeled dose, evidence carried over from the same molecule at another dose.

Lean Mass Evidence (20): randomized DXA body-composition data for the molecule. 16 = randomized DXA substudy of 100 or more participants with about one-quarter or less of lost weight as lean mass; 13 = randomized DXA substudy of 100 or more participants with more than one-quarter of lost weight as lean mass; 11 = only small (under 100 participants) or short randomized DXA studies; 9 = no randomized DXA data for the formulation.

Not yet scored: Wegovy tablets (oral semaglutide, FDA-approved December 2025), the Wegovy 7.2 mg injection dose (FDA-approved March 2026), Ozempic tablets (oral semaglutide 1.5, 4 and 9 mg), and Foundayo (orforglipron, FDA-approved April 2026).

Methodology and scores compiled by Biomeme, September 2026. Sources are listed on each drug page.

20

Transcriptomic Evidence

20

Weight Loss Efficacy

20

Tolerability

20

CV Evidence

20

Lean Mass Evidence

Published Grade Scale

A+ 95–100
A 88–94
A− 82–87
B+ 76–81
B 68–75
B− 62–67
C+ 54–61
C 44–53
C− 38–43
D 30–37
F < 30
#1
84 A−

Zepbound

Tirzepatide

The largest mean weight loss of any drug scored here — tirzepatide for weight management and sleep apnea.
#2
83 A−

Wegovy

Semaglutide 2.4 mg

The weight management formulation with the strongest cardiovascular evidence.
#3
81 B+

Mounjaro

Tirzepatide

Dual GIP/GLP-1 agonist for type 2 diabetes, now with a cardiovascular risk-reduction indication.
#4
77 B+

Ozempic

Semaglutide 0.5–2.0 mg

The most recognized GLP-1 brand — glycemic control plus cardiovascular and kidney outcome indications in type 2 diabetes.
#5
69 B

Rybelsus

Oral Semaglutide 3/7/14 mg

The first oral GLP-1 peptide — a daily tablet with a cardiovascular risk-reduction indication and strict dosing rules.
#6
67 B−

Victoza

Liraglutide 1.8 mg

The proven daily GLP-1 for diabetes with established cardiovascular benefit.
#7
66 B−

Saxenda

Liraglutide 3.0 mg

First-generation daily GLP-1 for weight management — less weight loss than the weekly options.

Frequently Asked Questions

What is a GLP-1 receptor agonist?
GLP-1 receptor agonists are a class of medications that mimic the incretin hormone GLP-1, enhancing insulin secretion, suppressing glucagon, slowing gastric emptying, and reducing appetite. They are FDA-approved for type 2 diabetes and/or chronic weight management, and some also carry cardiovascular, kidney, liver (MASH) or sleep apnea indications. Tirzepatide also activates the GIP receptor.
How is the GLP-1 Clinical Evidence Score calculated?
Each drug is evaluated across five dimensions (20 points each, 100 total): transcriptomic evidence for the molecule, weight loss in the brand's pivotal trial, discontinuation because of adverse reactions, cardiovascular outcome evidence, and randomized DXA lean-mass data. The scoring rules for each dimension are published in the methodology section above. Scores reflect published clinical literature and trial findings, not individual patient response predictions.
What does the Transcriptomic Evidence score mean?
This dimension reflects how thoroughly each molecule's effects on gene expression have been characterized in published human transcriptomic studies. It is scored per molecule, so brands that share a molecule share a score. It is not a measure of how well a drug works, and it does not describe what Inflammation Compass measures.
Should I choose my GLP-1 medication based on this scorecard?
No. This comparative scorecard is strictly for educational and informational purposes and does not constitute medical advice. Medication selection must be made with a licensed prescribing provider based on individual medical history, clinical indications, insurance coverage, and treatment goals.
Founding Cohort

Track Your Immune Patterns on GLP-1 — Cohort Now Forming

See what your immune system is doing while you take a GLP-1. Reserve your spot today to lock in founding pricing before the general public.