Semaglutide vs dulaglutide

Semaglutide and dulaglutide are both GLP-1 receptor agonists approved in the US and EU for type 2 diabetes. Semaglutide (Ozempic, Wegovy) is also approved for weight management and comes as a tablet, while dulaglutide (Trulicity) is fused to an antibody fragment. This page compares their study results.

Best randomized result by outcome

For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.

Best randomized result by outcome for Semaglutide, Dulaglutide (Trulicity)
Outcome	Semaglutide	Dulaglutide (Trulicity)
Kidney functionKidney and urinaryCompared as: share of people in the arm that got the peptide, in %	1.8% Incidence Placebo: 2.2% Dose studied: 2.4 mg once weeklyn = 17,6042024	7.6% proportion with primary composite kidney outcome, dulaglutide · dulaglutide 1·5 mg, overall population Dose studied: 1·5 mg weeklyn = 13,1652026
Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in %	6.5% primary end-point event rate Placebo: 8% Dose studied: 2.4 mg once weeklyn = 17,6042023	12% Primary outcome Placebo: 13.4% Dose studied: 1.5 mg weeklyMedian follow-up 5.4 yearsn = 9,9012019
Body weightMetabolic and weightCompared as: difference from placebo, in kg	−9.1 kg Total body weight change Dose studied: 2.4 mg/wk24 weeksn = 1012026	−2.9 kg Baseline-adjusted difference in weight change Dose studied: 1.5 mg once weekly12 weeksn = 2552023
Glycemic controlMetabolic and weightCompared as: difference from placebo, in %	−1.6 to −0.4% Estimated treatment difference Dose studied: 2.5-40 mg once daily26 weeksn not reported2017	−1% HbA1c change difference Dose studied: 1.5 mg once weekly28 weeksn = 2912023
Quality of lifeWhole bodyCompared as: value in the arm that got the peptide, in points	7.3 points Score change · semaglutide 7 mg Dose studied: 7 mg daily52 weeksn not reported2021	3.3 points Score change Dose studied: 0.75 mg52 weeksn not reported2021
Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in %	41.8% Gastrointestinal adverse events Dose studied: 1.0 mg once weekly56 weeksn = 8132018	47.4% Gastrointestinal adverse events Placebo: 34.1% Dose studied: 1.5 mg weeklyMedian follow-up 5.4 yearsn = 9,9012019
Adverse eventsWhole bodyCompared as: value in the arm that got the peptide, in %	86.2% Adverse events · semaglutide 0.5 mg Dose studied: 0.5 mg56 weeksn = 6012018	82% Adverse events Dose studied: 0.75 mg weekly52 weeksn = 652020

Kidney functionKidney and urinaryCompared as: share of people in the arm that got the peptide, in %
- Semaglutide
  1.8%
  Incidence
  Placebo: 2.2%
  Dose studied: 2.4 mg once weeklyn = 17,6042024
- Dulaglutide (Trulicity)
  7.6%
  proportion with primary composite kidney outcome, dulaglutide · dulaglutide 1·5 mg, overall population
  Dose studied: 1·5 mg weeklyn = 13,1652026
Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in %
- Semaglutide
  6.5%
  primary end-point event rate
  Placebo: 8%
  Dose studied: 2.4 mg once weeklyn = 17,6042023
- Dulaglutide (Trulicity)
  12%
  Primary outcome
  Placebo: 13.4%
  Dose studied: 1.5 mg weeklyMedian follow-up 5.4 yearsn = 9,9012019
Body weightMetabolic and weightCompared as: difference from placebo, in kg
- Semaglutide
  −9.1 kg
  Total body weight change
  Dose studied: 2.4 mg/wk24 weeksn = 1012026
- Dulaglutide (Trulicity)
  −2.9 kg
  Baseline-adjusted difference in weight change
  Dose studied: 1.5 mg once weekly12 weeksn = 2552023
Glycemic controlMetabolic and weightCompared as: difference from placebo, in %
- Semaglutide
  −1.6 to −0.4%
  Estimated treatment difference
  Dose studied: 2.5-40 mg once daily26 weeksn not reported2017
- Dulaglutide (Trulicity)
  −1%
  HbA1c change difference
  Dose studied: 1.5 mg once weekly28 weeksn = 2912023
Quality of lifeWhole bodyCompared as: value in the arm that got the peptide, in points
- Semaglutide
  7.3 points
  Score change · semaglutide 7 mg
  Dose studied: 7 mg daily52 weeksn not reported2021
- Dulaglutide (Trulicity)
  3.3 points
  Score change
  Dose studied: 0.75 mg52 weeksn not reported2021
Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in %
- Semaglutide
  41.8%
  Gastrointestinal adverse events
  Dose studied: 1.0 mg once weekly56 weeksn = 8132018
- Dulaglutide (Trulicity)
  47.4%
  Gastrointestinal adverse events
  Placebo: 34.1%
  Dose studied: 1.5 mg weeklyMedian follow-up 5.4 yearsn = 9,9012019
Adverse eventsWhole bodyCompared as: value in the arm that got the peptide, in %
- Semaglutide
  86.2%
  Adverse events · semaglutide 0.5 mg
  Dose studied: 0.5 mg56 weeksn = 6012018
- Dulaglutide (Trulicity)
  82%
  Adverse events
  Dose studied: 0.75 mg weekly52 weeksn = 652020

Outcomes with a randomized result for one peptide only (5 outcomes)

The other peptides have no randomized result on the same measure, so these results cannot be set side by side.

Outcomes with a randomized result for one peptide only: Semaglutide, Dulaglutide (Trulicity)
Outcome	Semaglutide	Dulaglutide (Trulicity)
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg	−3.84 mm Hg SBP change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026	No comparable result 10 randomized-trial results measure it in another way or another unit.
Inflammation markersImmune and inflammationCompared as: difference from placebo, in %	−18.08% hsCRP change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026	No comparable result 6 randomized-trial results measure it in another way or another unit.
LipidsMetabolic and weightCompared as: difference from placebo, in %	−7% Total cholesterol change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026	No comparable result 20 randomized-trial results measure it in another way or another unit.
Cardiometabolic risk factorsMetabolic and weightCompared as: value in the arm that got the peptide, in %	−61.1% Relative risk score change Placebo: −12.9% Dose studied: 2.4 mg68 weeksn = 1,5832023	No comparable result 4 randomized-trial results measure it in another way or another unit.
Liver fat and liver functionLiverCompared as: difference from placebo, in percentage points	28.7 percentage points Estimated difference Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025	No comparable result 6 randomized-trial results measure it in another way or another unit.

Blood pressureCardiovascularCompared as: difference from placebo, in mm hg
- Semaglutide
  −3.84 mm Hg
  SBP change at 13 weeks
  Dose studied: maximum 14 mg once dailyn = 9,6502026
- Dulaglutide (Trulicity)
  No comparable result
  10 randomized-trial results measure it in another way or another unit.
Inflammation markersImmune and inflammationCompared as: difference from placebo, in %
- Semaglutide
  −18.08%
  hsCRP change at 13 weeks
  Dose studied: maximum 14 mg once dailyn = 9,6502026
- Dulaglutide (Trulicity)
  No comparable result
  6 randomized-trial results measure it in another way or another unit.
LipidsMetabolic and weightCompared as: difference from placebo, in %
- Semaglutide
  −7%
  Total cholesterol change at 13 weeks
  Dose studied: maximum 14 mg once dailyn = 9,6502026
- Dulaglutide (Trulicity)
  No comparable result
  20 randomized-trial results measure it in another way or another unit.
Cardiometabolic risk factorsMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Semaglutide
  −61.1%
  Relative risk score change
  Placebo: −12.9%
  Dose studied: 2.4 mg68 weeksn = 1,5832023
- Dulaglutide (Trulicity)
  No comparable result
  4 randomized-trial results measure it in another way or another unit.
Liver fat and liver functionLiverCompared as: difference from placebo, in percentage points
- Semaglutide
  28.7 percentage points
  Estimated difference
  Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025
- Dulaglutide (Trulicity)
  No comparable result
  6 randomized-trial results measure it in another way or another unit.

Comparing 2 peptides · Data version 308560

Only differences

Swipe sideways to see every peptide.

Comparison of Semaglutide, Dulaglutide (Trulicity)
Peptide	Synthetic analog Semaglutide	Conjugate Dulaglutide (Trulicity)
Identity
Kind	Synthetic analog	Conjugate
Area	Weight and metabolic	Weight and metabolic
Evidence
Amount of evidence	4,624	1,919
Evidence level	Has results from studies in people	Has results from studies in people
Safety
Safety results	1,224 (1,221 in people)	488 (445 in people)
Status
Approval
Sport (WADA)
Registered trials	663 · 284 active124 more mention it but do not test it	124 · 15 active19 more mention it but do not test it

Shared outcomes

Glycemic control1232
Body weight1147
Adverse events1053
Gastrointestinal adverse events524
Cardiovascular events307
Liver fat and liver function199
Kidney function199
Lipids155
Pharmacokinetics137
Mortality127
Blood pressure113
Appetite and food intake112

Approval and sport status

From the regulatory data of each peptide.

Semaglutide
The FDA label for Ozempic says: “Adjunct to diet and exercise for glycemic control in adults with type 2 diabetes; reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease; reduce the risk of sustained eGFR decline…”
Dulaglutide (Trulicity)
The FDA label for Trulicity says: “A GLP-1 analog fused to an IgG4 Fc region, approved for type 2 diabetes and specified cardiovascular risk reduction”

Amount of evidence by outcome

Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.

Study results per shared outcome group and evidence class
Outcome group	Semaglutide	Dulaglutide (Trulicity)
Glycemic controlMetabolic and weight	66866512	564537261
Body weightMetabolic and weight	969954105	1781726
Adverse eventsWhole body	7757723	27823543
Gastrointestinal adverse eventsGastrointestinal	345345	179179
Cardiovascular eventsWhole body	2672634	4040
Liver fat and liver functionMusculoskeletal	17917441	20191
Kidney functionKidney and urinary	1361351	63567
LipidsMetabolic and weight	1181171	37352
PharmacokineticsPharmacology	93894	44404
MortalityWhole body	1041031	2323
Blood pressureEndocrine and hormones	9999	14131
Appetite and food intakeNervous system and cognition	97952	15141

Sequence alignment

Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.

Against Glucagon-like peptide 1 (7-37)Semaglutide, Dulaglutide (Trulicity)

Semaglutide differs from Glucagon-like peptide 1 (7-37) at 2 positions and carries 1 added group.

Top row: Glucagon-like peptide 1 (7-37) (parent, numbered from 7)
Bottom row: Semaglutide

HEGTFTSDV

SSYLEGQAA

EFIAWLVGR

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 8: Ala is replaced by Aib, an amino acid that is not one of the standard 20.
2Position 26: Lys carries an added group: lipidation.
3Position 34: Lys is replaced by Arg.

Dulaglutide (Trulicity) differs from Glucagon-like peptide 1 (7-37) at 246 positions.

Top row: Glucagon-like peptide 1 (7-37) (parent, numbered from 7)
Bottom row: Dulaglutide (Trulicity)

HEGTFTSDV

SSY

FIAW

VKG

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 8: Ala is replaced by Gly.
2Position 14: Leu is added.
3Position 15: Glu is added.
4Position 16: Glu is added.
5Position 17: Gln is added.
6Position 18: Ala is added.
7Position 19: Ala is added.
8Position 20: Lys is added.
9Position 21: Glu is added.
10Position 22: Phe is added.
11Position 23: Ile is added.
12Position 24: Ala is added.
13Position 25: Trp is added.
14Position 27: Val is added.
15Position 28: Lys is added.
16Position 29: Gly is added.
17Position 30: Gly is added.
18Position 31: Gly is added.
19Position 32: Gly is added.
20Position 33: Gly is added.
21Position 34: Gly is added.
22Position 35: Gly is added.
23Position 36: Ser is added.
24Position 37: Gly is added.
25Position 38: Gly is added.
26Position 39: Gly is added.
27Position 40: Gly is added.
28Position 41: Ser is added.
29Position 42: Gly is added.
30Position 43: Gly is added.
31Position 44: Gly is added.
32Position 45: Gly is added.
33Position 46: Ser is added.
34Position 47: Ala is added.
35Position 48: Glu is added.
36Position 49: Ser is added.
37Position 50: Lys is added.
38Position 51: Tyr is added.
39Position 52: Gly is added.
40Position 53: Pro is added.
41Position 54: Pro is added.
42Position 55: Cys is added.
43Position 56: Pro is added.
44Position 57: Pro is added.
45Position 58: Cys is added.
46Position 59: Pro is added.
47Position 60: Ala is added.
48Position 61: Pro is added.
49Position 63: Ala is added.
50Position 64: Ala is added.
51Position 65: Gly is added.
52Position 67: Pro is added.
53Position 68: Ser is added.
54Position 69: Val is added.
55Position 70: Phe is added.
56Position 71: Leu is added.
57Position 72: Phe is added.
58Position 73: Pro is added.
59Position 74: Pro is added.
60Position 75: Lys is added.
61Position 76: Pro is added.
62Position 77: Lys is added.
63Position 78: Asp is added.
64Position 79: Thr is added.
65Position 80: Leu is added.
66Position 81: Met is added.
67Position 82: Ile is added.
68Position 83: Ser is added.
69Position 84: Arg is added.
70Position 85: Thr is added.
71Position 86: Pro is added.
72Position 87: Glu is added.
73Position 88: Val is added.
74Position 89: Thr is added.
75Position 90: Cys is added.
76Position 91: Val is added.
77Position 92: Val is added.
78Position 93: Val is added.
79Position 94: Asp is added.
80Position 95: Val is added.
81Position 96: Ser is added.
82Position 97: Gln is added.
83Position 98: Glu is added.
84Position 99: Asp is added.
85Position 100: Pro is added.
86Position 101: Glu is added.
87Position 102: Val is added.
88Position 104: Phe is added.
89Position 105: Asn is added.
90Position 106: Trp is added.
91Position 107: Tyr is added.
92Position 108: Val is added.
93Position 109: Asp is added.
94Position 110: Gly is added.
95Position 111: Val is added.
96Position 112: Glu is added.
97Position 113: Val is added.
98Position 114: His is added.
99Position 115: Asn is added.
100Position 117: Lys is added.
101Position 118: Thr is added.
102Position 119: Lys is added.
103Position 120: Pro is added.
104Position 121: Arg is added.
105Position 122: Glu is added.
106Position 123: Glu is added.
107Position 124: Gln is added.
108Position 125: Phe is added.
109Position 126: Asn is added.
110Position 127: Ser is added.
111Position 128: Thr is added.
112Position 129: Tyr is added.
113Position 130: Arg is added.
114Position 131: Val is added.
115Position 132: Val is added.
116Position 133: Ser is added.
117Position 134: Val is added.
118Position 135: Leu is added.
119Position 136: Thr is added.
120Position 137: Val is added.
121Position 138: Leu is added.
122Position 139: His is added.
123Position 140: Gln is added.
124Position 141: Asp is added.
125Position 142: Trp is added.
126Position 143: Leu is added.
127Position 144: Asn is added.
128Position 145: Gly is added.
129Position 146: Lys is added.
130Position 147: Glu is added.
131Position 148: Tyr is added.
132Position 149: Lys is added.
133Position 150: Cys is added.
134Position 151: Lys is added.
135Position 152: Val is added.
136Position 153: Ser is added.
137Position 154: Asn is added.
138Position 155: Lys is added.
139Position 156: Gly is added.
140Position 157: Leu is added.
141Position 158: Pro is added.
142Position 159: Ser is added.
143Position 160: Ser is added.
144Position 161: Ile is added.
145Position 162: Glu is added.
146Position 163: Lys is added.
147Position 164: Thr is added.
148Position 165: Ile is added.
149Position 166: Ser is added.
150Position 167: Lys is added.
151Position 170: Gly is added.
152Position 171: Gln is added.
153Position 172: Pro is added.
154Position 173: Arg is added.
155Position 174: Glu is added.
156Position 175: Pro is added.
157Position 176: Gln is added.
158Position 177: Val is added.
159Position 178: Tyr is added.
160Position 179: Thr is added.
161Position 180: Leu is added.
162Position 181: Pro is added.
163Position 182: Pro is added.
164Position 183: Ser is added.
165Position 184: Gln is added.
166Position 185: Glu is added.
167Position 187: Met is added.
168Position 188: Thr is added.
169Position 189: Lys is added.
170Position 190: Asn is added.
171Position 191: Gln is added.
172Position 192: Val is added.
173Position 193: Ser is added.
174Position 194: Leu is added.
175Position 195: Thr is added.
176Position 196: Cys is added.
177Position 197: Leu is added.
178Position 198: Val is added.
179Position 199: Lys is added.
180Position 200: Gly is added.
181Position 202: Tyr is added.
182Position 203: Pro is added.
183Position 204: Ser is added.
184Position 205: Asp is added.
185Position 208: Val is added.
186Position 209: Glu is added.
187Position 211: Glu is added.
188Position 212: Ser is added.
189Position 213: Asn is added.
190Position 214: Gly is added.
191Position 215: Gln is added.
192Position 216: Pro is added.
193Position 217: Glu is added.
194Position 218: Asn is added.
195Position 219: Asn is added.
196Position 220: Tyr is added.
197Position 221: Lys is added.
198Position 222: Thr is added.
199Position 223: Thr is added.
200Position 224: Pro is added.
201Position 225: Pro is added.
202Position 226: Val is added.
203Position 227: Leu is added.
204Position 228: Asp is added.
205Position 229: Ser is added.
206Position 230: Asp is added.
207Position 231: Gly is added.
208Position 232: Ser is added.
209Position 233: Phe is added.
210Position 234: Phe is added.
211Position 235: Leu is added.
212Position 236: Tyr is added.
213Position 237: Ser is added.
214Position 238: Arg is added.
215Position 240: Thr is added.
216Position 242: Asp is added.
217Position 244: Ser is added.
218Position 245: Arg is added.
219Position 246: Trp is added.
220Position 247: Gln is added.
221Position 248: Glu is added.
222Position 250: Asn is added.
223Position 251: Val is added.
224Position 252: Phe is added.
225Position 253: Ser is added.
226Position 254: Cys is added.
227Position 255: Ser is added.
228Position 256: Val is added.
229Position 257: Met is added.
230Position 258: His is added.
231Position 259: Glu is added.
232Position 260: Ala is added.
233Position 261: Leu is added.
234Position 262: His is added.
235Position 263: Asn is added.
236Position 264: His is added.
237Position 265: Tyr is added.
238Position 266: Thr is added.
239Position 267: Gln is added.
240Position 268: Lys is added.
241Position 269: Ser is added.
242Position 270: Leu is added.
243Position 271: Ser is added.
244Position 272: Leu is added.
245Position 273: Ser is added.
246Position 36: Arg is replaced by Leu.

Trials side by side

Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.

Semaglutide663 registered trials

Top 3 of 663 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT03574597

Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity

Novo Nordisk A/S17,604 participants24 Oct 2018 to 29 Jun 2023

Overweight · Obesity

Trial page ClinicalTrials.gov

CompletedPhase 3Results postedNCT03914326

A Heart Disease Study of Semaglutide in Patients With Type 2 Diabetes

Novo Nordisk A/S9,651 participants17 Jun 2019 to 23 Aug 2024

Diabetes Mellitus, Type 2

Trial page ClinicalTrials.gov

CompletedPhase 3Results postedNCT03819153

A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney Disease

Novo Nordisk A/S3,533 participants17 Jun 2019 to 9 Jan 2024

Diabetes Mellitus, Type 2

Trial page ClinicalTrials.gov

124 more mention it but do not test it. They only measure it or name it in their text.

Dulaglutide (Trulicity)124 registered trials

Top 3 of 124 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT04255433