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The cardiovascular outcome question is the single largest open-source efficacy question in the category and the one most likely to either compress or expand the clinical differentiation between triples, duals, and pure GLP-1 in 2027-2028
Mayo Clinics data has women on tirzepatide plus hormone therapy losing 19.2% of body weight against 14% on tirzepatide alone
There are concerns
Its impact does not depend on testosterone, estrogen, progesterone, or thyroid levels
Tirzepatide targets two hormonal pathways (GLP-1 and GIP) instead of one, and clinical trials consistently show it produces greater weight loss
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