Dulaglutide (Trulicity) acts on the GLP-1 receptor and is approved in the US and EU for type 2 diabetes. Tirzepatide (Mounjaro, Zepbound) acts on both the GIP and GLP-1 receptors and is also approved for weight management, and both have many studies in people. This page compares their study results.
Comparing 2 peptides · Data version 308560
Swipe sideways to see every peptide.
| Peptide | Conjugate Dulaglutide (Trulicity) | Synthetic analog Tirzepatide |
|---|---|---|
| Identity | ||
| Kind | Conjugate | Synthetic analog |
| Area | Weight and metabolic | Weight and metabolic |
| Evidence | ||
| Amount of evidence | 1,919 | 2,165 |
| Evidence level | Has results from studies in people | Has results from studies in people |
| Safety | ||
| Safety results | 488 (445 in people) | 462 (462 in people) |
| Status | ||
| Approval | ||
| Sport (WADA) | ||
| Registered trials | 124 · 15 active19 more mention it but do not test it | 254 · 162 active47 more mention it but do not test it |
Shared outcomes
From the regulatory data of each peptide.
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”
The FDA label for Mounjaro says: “Adjunct to diet and exercise for glycemic control in adults and pediatric patients 10 years and older with type 2 diabetes; reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes at high risk for these events”
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.
| Outcome group | Dulaglutide (Trulicity) | Tirzepatide |
|---|---|---|
| Glycemic controlMetabolic and weight | 564537261 | 36435581 |
| Body weightMusculoskeletal | 1781726 | 521501182 |
| Adverse eventsWhole body | 27823543 | 213213 |
| Gastrointestinal adverse eventsGastrointestinal | 179179 | 179179 |
| Cardiovascular eventsCardiovascular | 4040 | 1551523 |
| LipidsMetabolic and weight | 37352 | 79763 |
| Kidney functionKidney and urinary | 63567 | 40391 |
| MortalityWhole body | 2323 | 635724 |
| Liver fat and liver functionLiver | 20191 | 5353 |
| Inflammation markersRespiratory | 6822451 | 41347 |
| Quality of lifeWhole body | 2121 | 4545 |
| Blood pressureCardiovascular | 14131 | 5151 |
PepBank is a research reference. Talk to a doctor before you use any peptide.
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.
| Outcome | Dulaglutide (Trulicity) | Tirzepatide |
|---|---|---|
| Cardiovascular eventsCardiovascularCompared as: share of people in the arm that got the peptide, in % | 27.4% proportion with primary cardiorenal end point, dulaglutide · dulaglutide 1.5 mg Dose studied: 1.5 mg weeklymedian treatment duration 46.9 monthsn = 13,1652026 | 12.2% Event proportion Dose studied: up to 15 mg once weeklyn = 13,1652025 |
| Glycemic controlMetabolic and weightCompared as: difference from placebo, in % | −1% HbA1c change difference Dose studied: 1.5 mg once weekly28 weeksn = 2912023 | −0.4% HbA1c mean difference Dose studied: 2.5 mg for 4 weeks, 5.0 mg for 8 weeks12 weeksn not reported2026 |
| Body weightMetabolic and weightCompared as: difference from placebo, in kg | −2.9 kg Baseline-adjusted difference in weight change Dose studied: 1.5 mg once weekly12 weeksn = 2552023 | −8.7 kg treatment difference Dose studied: 2.5 mg for 4 weeks, 5.0 mg for 8 weeks12 weeksn not reported2026 |
| Cardiometabolic risk factorsMetabolic and weightCompared as: value in the arm that got the peptide, in % | 56.5% Composite endpoint prevalence · Dulaglutide at week 52 Dose studied: 0.75 mg52 weeksn not reported2024 | 31.7% Composite endpoint prevalence · Tirzepatide 5 mg at week 52 Dose studied: 5 mg52 weeksn not reported2024 |
| Kidney functionKidney and urinaryCompared as: value in the arm that got the peptide, in % | −22.5% UACR change · dulaglutide 1.5 mg Dose studied: 1.5 mg weekly52 weeksn not reported2018 | −19.3% UACR percent change · tirzepatide 5 mg Dose studied: 5 mgweek 40/42n not reported2025 |
| Quality of lifeWhole bodyCompared as: value in the arm that got the peptide, in points | 3.3 points Score change Dose studied: 0.75 mg52 weeksn not reported2021 | 5.45 points General Health score change Dose studied: maximum tolerated dose72 weeksn not reported2026 |
| Adverse eventsMetabolic and weightCompared as: value in the arm that got the peptide, in % | 3% Discontinuation Dose studied: 0.75 mg weekly52 weeksn = 652020 | 6.3% discontinuation due to adverse events Placebo: 1.4% Dose studied: up to 15 mg once weeklyat least 52 weeksn = 7312025 |
| Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in % | 20% Nausea · dulaglutide 1.5 mg Dose studied: 1.5 mg weeklyn = 1922018 | 17 to 22% Nausea Dose studied: 5, 10 or 15 mg once weekly40 weeksn not reported2021 |
27.4%
proportion with primary cardiorenal end point, dulaglutide · dulaglutide 1.5 mg
Dose studied: 1.5 mg weeklymedian treatment duration 46.9 monthsn = 13,1652026
12.2%
Event proportion
Dose studied: up to 15 mg once weeklyn = 13,1652025
−1%
HbA1c change difference
Dose studied: 1.5 mg once weekly28 weeksn = 2912023
−0.4%
HbA1c mean difference
Dose studied: 2.5 mg for 4 weeks, 5.0 mg for 8 weeks12 weeksn not reported2026
−2.9 kg
Baseline-adjusted difference in weight change
Dose studied: 1.5 mg once weekly12 weeksn = 2552023
−8.7 kg
treatment difference
Dose studied: 2.5 mg for 4 weeks, 5.0 mg for 8 weeks12 weeksn not reported2026
56.5%
Composite endpoint prevalence · Dulaglutide at week 52
Dose studied: 0.75 mg52 weeksn not reported2024
31.7%
Composite endpoint prevalence · Tirzepatide 5 mg at week 52
Dose studied: 5 mg52 weeksn not reported2024
−22.5%
UACR change · dulaglutide 1.5 mg
Dose studied: 1.5 mg weekly52 weeksn not reported2018
−19.3%
UACR percent change · tirzepatide 5 mg
Dose studied: 5 mgweek 40/42n not reported2025
3.3 points
Score change
Dose studied: 0.75 mg52 weeksn not reported2021
5.45 points
General Health score change
Dose studied: maximum tolerated dose72 weeksn not reported2026
3%
Discontinuation
Dose studied: 0.75 mg weekly52 weeksn = 652020
6.3%
discontinuation due to adverse events
Placebo: 1.4%
Dose studied: up to 15 mg once weeklyat least 52 weeksn = 7312025
20%
Nausea · dulaglutide 1.5 mg
Dose studied: 1.5 mg weeklyn = 1922018
17 to 22%
Nausea
Dose studied: 5, 10 or 15 mg once weekly40 weeksn not reported2021
The other peptides have no randomized result on the same measure, so these results cannot be set side by side.
| Outcome | Dulaglutide (Trulicity) | Tirzepatide |
|---|---|---|
| Metabolic pathways and metabolomicsMetabolic and weightCompared as: value in the arm that got the peptide, in mg/dl | No comparable result 3 randomized-trial results measure it in another way or another unit. | −0.69 mg/dL SUA change · tirzepatide 5 mg Placebo: −0.18 mg/dL Dose studied: 5 mg72 weeksn = 2,5392026 |
| Heart functionCardiovascularCompared as: difference from placebo, in points | No comparable result 7 randomized-trial results measure it in another way or another unit. | 6.9 points between-group difference Dose studied: up to 15 mg once weeklyat least 52 weeksn = 7312025 |
| Bone and jointMusculoskeletalCompared as: value in the arm that got the peptide, in % | No comparable result 2 randomized-trial results measure it in another way or another unit. | 33.5% ACR50 Dose studied: US-approved dosesn = 2712026 |
| Receptor activity and mechanismNervous system and cognitionCompared as: difference from placebo, in pmol/l | −0.7 pmol/L Median within-subject copeptin difference Dose studied: 1.5 mg once weekly3 weeksn = 542026 | No comparable result 5 randomized-trial results measure it in another way or another unit. |
No comparable result
3 randomized-trial results measure it in another way or another unit.
−0.69 mg/dL
SUA change · tirzepatide 5 mg
Placebo: −0.18 mg/dL
Dose studied: 5 mg72 weeksn = 2,5392026
No comparable result
7 randomized-trial results measure it in another way or another unit.
6.9 points
between-group difference
Dose studied: up to 15 mg once weeklyat least 52 weeksn = 7312025
No comparable result
2 randomized-trial results measure it in another way or another unit.
33.5%
ACR50
Dose studied: US-approved dosesn = 2712026
−0.7 pmol/L
Median within-subject copeptin difference
Dose studied: 1.5 mg once weekly3 weeksn = 542026
No comparable result
5 randomized-trial results measure it in another way or another unit.
Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.
Dulaglutide (Trulicity) differs from GLP-1 (7-37) at 246 positions.
What is different
Tirzepatide differs from Gastric inhibitory polypeptide (GIP) at 11 positions and in 1 end segment.
What is different
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.
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)
Eli Lilly and Company13,299 participants29 May 2020 to 12 Jun 2025
Type 2 Diabetes Mellitus
Eli Lilly and Company9,901 participants22 Jul 2011 to 21 Aug 2018
Cardiovascular Disease · Diabetes Mellitus, Type 2
Eli Lilly and Company1,842 participants5 Apr 2018 to 10 Oct 2019
Diabetes Mellitus, Type 2
19 more mention it but do not test it. They only measure it or name it in their text.
Top 3 of 254 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)
Eli Lilly and Company13,299 participants29 May 2020 to 12 Jun 2025
Type 2 Diabetes Mellitus
Eli Lilly and Company2,539 participants4 Dec 2019 to 6 Jul 2024
Overweight · Obesity
Eli Lilly and Company2,002 participants20 Nov 2018 to 22 Apr 2021
Type 2 Diabetes Mellitus
47 more mention it but do not test it. They only measure it or name it in their text.
In PepBank now:147 peptides, 6 blends and 13 other compounds97,577 study results from 17,383 studies8,473 clinical trialsUpdated