Semaglutide and tirzepatide are typically evaluated through dose escalation, yet many patients in routine care do not reach a recommended maintenance dose due to tolerability, access, cost, supply or individualized goals. Here we used sustained 0.25 mg-only semaglutide and sustained 2.5 mg-only tirzepatide exposures as real-world proxies for “microdosing” and analyzed de-identified electronic health records from a federated system of 29 million patients. Among 490,072 semaglutide-treated patient
