Novo NVO announced new real-world data from the COMPETE SWITCH Cardiovascular (CV) study comparing treatment strategies in adults with type II diabetes (T2D) who were already receiving a 1-mg dose of Ozempic (semaglutide) injection.
The analysis found that patients who increased their Ozempic dose had a lower observed risk of major adverse cardiovascular events (MACE) than those who switched to Lilly’s LLY Mounjaro (tirzepatide).
Ozempic and Mounjaro are competing therapies in the U.S. diabetes market.
Ozempic is a once-weekly GLP-1 receptor agonist developed by Novo. It is approved with diet and exercise to improve blood-sugar control and to lower the risk of major cardiovascular events, including heart attack, stroke and cardiovascular death, in adults with T2D and established cardiovascular disease. It is also approved for adults with T2D and chronic kidney disease to reduce the risk of sustained eGFR decline, end-stage kidney disease and cardiovascular death.
Meanwhile, Lilly’s Mounjaro is approved, in combination with diet and exercise, to improve blood-sugar control in patients aged 10 years and older with T2D. In August 2026, it also gained approval to reduce the risk of MACE in adults with T2D who are at high cardiovascular risk.
Year to date, shares of Novo have lost 22.2% against the industry’s 14.9% growth.
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NVO’s Treatment Patterns Observed in COMPETE SWITCH CV Study
Novo conducted the COMPETE SWITCH CV study to assess real-world treatment patterns and compare outcomes in patients who intensified Ozempic to 2 mg versus those who switched to Mounjaro.
Within 365 days, 67.2% remained on Ozempic 1 mg, 29.2% increased their dose to 2 mg, and 3.6% switched to Mounjaro. By 720 days of follow-up, 57.4% remained on semaglutide 1 mg, while 36.9% had escalated to 2 mg and 5.7% had switched to Mounjaro.
After adjustment for between-group differences, patients who increased their dose to Ozempic 2 mg had a statistically significant 6% lower risk of MACE than those who switched to Mounjaro, including doses of up to 15 mg. A subset of patients with available HbA1c or weight data showed similar findings. MACE included all-cause death, heart attack and stroke.
For Novo, the findings provided additional real-world evidence supporting continued use of higher-dose Ozempic among appropriate patients who require treatment intensification.
However, the study showed an association, not proof, that Ozempic 2 mg directly reduces cardiovascular risk more than Mounjaro. Importantly, safety outcomes were not evaluated in this analysis.