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Correspondence to Author: Rafaela Rivero B. B. Cristofolini¹, Gabriel Leonardo Saraiva¹, Filipe Jabur L. Garcia¹, Daniella Campos Furtado¹, Talita L. de Castro Lousada¹, Pedro F. Morandini Lotfi¹, Lorena Almeida Fagundes¹, Isabeli Gomes de Oliveira¹, Joseilton Vilela de Carvalho¹, Bruno E. Silva Dorna¹, Regilane da Silva Batista¹, Elis Muraro Consolin¹, Roselene de Oliveira Carvalho¹, Diego Paulino Mariz¹, Wellington da Silva P. da Cunha¹, Délio T. Martins Malaquias¹, Rafaela Gonçalves Bueno¹, Michelli D. Martins Borges¹, Isabelle P. Santos¹, Julia Adelaide Januário¹, Gianluca F. Castro Sganzella¹, Marco Aurélio Silva Couto¹, Carlos Henrique B. Figueiredo de Mendonça², Larissa Bauer Machado³, Rubens Rodrigues Tudela⁴, Liliana Martins Occulate⁵, Giovana Casarini Yamashiro⁶, Maria Olivia de Oliveira Futuro Rodrigues⁷, Giovana Clausson Bitolo⁶, Christopher Aquino Pereira Lima⁶, Julienne F. C. Silva⁸, Maria Beatriz Mendonça Ventura⁴, Ana Laura Nogueira Ervilha⁹, Giulia Candido Campos Marcondes⁹, Elisa Lavezzo Amadeu⁹, Ana Paula Valente Pinho Mafetano⁹, João Pedro Arraes de Medeiros¹⁰, Matheus Barros Lisboa¹¹, Vanessa Iukari Fukushima¹², Ana Paula de Lima Tanaka¹³, Marcia Cristina Guimarães Siqueira¹⁴, Giovanna Guimarães Vilarinho Siqueira¹⁵, Thiago A. Rochetti Bezerra¹⁶. 

¹ Ribeirão Preto University (UNAERP), Guarujá Campus, Guarujá, São Paulo, Brazil.
² Federal University of Roraima (UFRR), Boa Vista, Roraima, Brazil.
³ Professor Franco Montoro Municipal College, Mogi Guaçu, São Paulo, Brazil.
⁴ São Judas Tadeu University (USJT), Cubatão, São Paulo, Brazil.
⁵ Central University of Paraguay, Faculty of Medicine, Ciudad del Este, Paraguay.
⁶ Nove de Julho University (UNINOVE), São Bernardo do Campo, São Paulo, Brazil.
⁷ University of Western São Paulo (UNOESTE), Guarujá, São Paulo, Brazil.
⁸ University of the Integration of the Americas (UNIDA), Ciudad del Este, Paraguay.
⁹ Faculty of Medical Sciences of São José dos Campos – Humanitas, São José dos Campos, São Paulo, Brazil.
¹⁰ Potiguar University (UnP), Natal, Rio Grande do Norte, Brazil.
¹¹ Metropolitan University Center of Amazonia (UNIFAMAZ), Belém, Pará, Brazil; Medical Residency in Orthopedics and Traumatology at the Brotherhood of Santa Casa de Misericórdia de Santos, Santos, São Paulo, Brazil.
¹² niversity Center of the State of Pará (CESUPA), Belém, Pará, Brazil; Medical Residency in Clinical Medicine at Irmandade da Santa Casa de Misericórdia de Santos, Santos, São Paulo, Brazil.
¹³ Cesumar University, Maringa, Paraná, Brazil.
¹⁴ Unitau, Graduate Program in Family and Community Health, Specialist Degree in Family and Community Medicine.
¹⁵ Unimes, Santos, São Paulo, Brazil.
¹⁶ Ribeirão Preto School of Medicine, USP. Ribeirão Preto, São Paulo, Brazil

DOI: 10.52338/jocem.2026.5500

Abstract:

Introduction: Tirzepatide is an innovation in the treatment of type 2 diabetes and obesity, combining GIP and GLP-1 agonism, promoting glycemic control, weight reduction, and sustained metabolic benefits. Clinical and pharmacovigilance studies elucidate its efficacy and the temporal behavior of adverse effects.
Objectives: To analyze the efficacy and safety of tirzepatide, correlating adverse events with duration of use in patients with type 2 diabetes and obesity; to describe the main events, compare frequencies between clinical profiles, and evaluate their relationship with treatment duration.
Methodology: Integrative review according to PRISMA guidelines, including publications from 2020–2025 in PubMed, Scopus, Web of Science, and Google Scholar databases. Thirty-two studies (clinical trials, observational studies, and pharmacovigilance studies) were selected. The analysis was descriptive and comparative, considering study type, treatment duration, and pattern of adverse events.
Results: Tirzepatide showed superiority over GLP-1 agonists alone, with mean reductions in HbA1c >2% and clinically significant weight loss, maintained in the long term. The most common adverse events were gastrointestinal, mild, and self-limiting, predominantly occurring in the first weeks of titration and decreasing with continued use. Final considerations: The safety profile is favorable, with rare serious events and predictable physiological adaptation. Tirzepatide is established as an effective, safe, and cost-effective option for the integrated management of type 2 diabetes and obesity.

Keywords: Tirzepatide; obesity; adverse effects; GLP-1; drug surveillance; weight loss.

Citation:

Dr. Thiago A. Rochetti Bezerra, Long-Term Safety Of Tirzepatide (Mounjaro): Relationship Between Duration Of Use And Adverse Events Compared With Semaglutide And Liraglutide. Journal of Clinical Endocrinology and Metabolism 2026.