Four months into the NHS tirzepatide programme, 130,000 patients are now receiving treatment. NICE publishes interim findings from its lower BMI threshold evidence review, and new data link GLP-1 receptor agonists to reduced atrial fibrillation risk.

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NHS Tirzepatide — 4-Month Data

• Cumulative patients: 130,000
• Prescribing rate: 8,500 new patients per week
• 16-week review completion rate: 89% of eligible patients have had a documented 16-week review
• Continuation rate: 76%

Outcomes at 16 weeks (n=68,000 with completed reviews):

• Mean weight loss: 8.1%
• ≥5% weight loss: 76%
• ≥10% weight loss: 31%
• ≥15% weight loss: 10%

Comorbidity outcomes (preliminary):

• HbA1c reduction in T2D patients: −9.4 mmol/mol at 16 weeks
• Blood pressure reduction: −7.2/−4.1 mmHg at 16 weeks
• Patient-reported quality of life: 71% reporting improvement

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NICE — Lower BMI Threshold Evidence Review: Interim Findings

Key interim findings:

Efficacy at BMI 27–29.9 kg/m²:

• GLP-1 receptor agonists produce clinically significant weight loss (8–15%) at BMI 27–29.9 kg/m² in RCTs
• Cardiometabolic outcomes are significantly improved in this BMI range in the SELECT and FLOW trials

Cost-effectiveness:

• Preliminary modelling suggests pharmacotherapy at BMI 27–29.9 kg/m² with established CVD or T2D is likely to be cost-effective at a £20,000–30,000/QALY threshold

Equity:

• Extending eligibility to BMI 27–29.9 kg/m² would disproportionately benefit South Asian and Black populations, who have higher cardiometabolic risk at lower BMI

Full findings expected Q4 2026.

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Semaglutide and Atrial Fibrillation — New Data

A large observational study published in JAMA Cardiology (n=180,000 patients with T2D, UK CPRD database) found that GLP-1 receptor agonist use was associated with a 23% reduction in new-onset atrial fibrillation (HR 0.77, 95% CI 0.71–0.84) compared with other glucose-lowering therapies.

The association was consistent across GLP-1 agonist subclasses and was independent of weight loss, suggesting a direct cardiac effect.

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This update is prepared for UK healthcare professionals. All prescribing decisions should reference current NICE guidance, the BNF, and individual patient clinical assessment.