Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial.

Billings LK, Winne L, Sharma P, Gomez-Valderas E, Chivukula KK, Kwan AYM

Annals of internal medicine4 Apr 2025Cited by 13 (Europe PMC)

PMID40183678DOI10.7326/annals-24-03849PepBankPUB-40183678

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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study8

7 results from studies that gave the peptide. 7 results from people.

01HumanRandomized controlled trialEfficacy outcome
In adults with inadequately controlled type 2 diabetes on lower-dose dulaglutide, switching to tirzepatide lowered HbA1c at week 40 by 0.77 percentage points more than escalating dulaglutide.
In plain wordsIn adults with type 2 diabetes not controlled on dulaglutide, switching to tirzepatide lowered HbA1c more than raising the dulaglutide dose.
Peptide
Tirzepatide
Outcome
DecreaseHbA1c change from baseline at week 40
Study
n = 282
Comparator
Dulaglutide 4.5 mg or maximum tolerated dose
Analysis
Primary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
15 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Measurements
HbA1c change
−1.44%
tirzepatide
HbA1c change
−0.67%
dulaglutide
Estimated treatment difference
−0.77%
tirzepatide vs dulaglutide
Source sentences
Summary
Change from baseline in HbA_1c at week 40 was -1.44% (SE, 0.07) with tirzepatide, 15 mg or MTD, and -0.67% (SE, 0.08) with dulaglutide, 4.5 mg or MTD (estimated treatment difference, -0.77% [95% CI, -0.98% to -0.56%; P < 0.001]).
2 context sentences(design, population, supporting numbers)
Summary · context
The primary end point was change from baseline in HbA_1c at week 40.
Summary · context
Adults with HbA_1c 7.0% or greater to 9.5% or less, stable body weight, body mass index of 25 kg/m² or greater, receiving a stable dose of dulaglutide (0.75 or 1.5 mg) for at least 6 months and 0 to 3 oral antihyperglycemic medications for at least 3 months.
Report a problemFND-4018367801
02HumanRandomized controlled trialEfficacy outcome
In adults with diabetes, dulaglutide escalation reduced HbA1c less than switching to tirzepatide at week 40.
In plain wordsIn adults with diabetes, increasing dulaglutide reduced blood sugar less than switching to tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseHbA1c change
Study
n = 282
Comparator
Tirzepatide 15 mg or maximum tolerated dose
Analysis
Primary
Outcome group
Glycemic control · Metabolic and weight
Studied dose
4.5 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Measurements
HbA1c change
−0.67%
dulaglutide, 4.5 mg or MTD
Standard error
0.08%
dulaglutide HbA1c change
HbA1c change
−1.44%
tirzepatide, 15 mg or MTD
Standard error
0.07%
tirzepatide HbA1c change
Estimated treatment difference
−0.77%
tirzepatide versus dulaglutide
95% CI of estimated treatment difference
−0.98 to −0.56%
tirzepatide versus dulaglutide
Source sentences
Summary
Change from baseline in HbA_1c at week 40 was -1.44% (SE, 0.07) with tirzepatide, 15 mg or MTD, and -0.67% (SE, 0.08) with dulaglutide, 4.5 mg or MTD (estimated treatment difference, -0.77% [95% CI, -0.98% to -0.56%; P < 0.001]).
2 context sentences(design, population, supporting numbers)
Summary · context
The primary end point was change from baseline in HbA_1c at week 40.
Summary · context
Escalation of dulaglutide to 4.5 mg or maximum tolerated dose (MTD) or switching to tirzepatide.
Report a problemFND-4018367805
03HumanRandomized controlled trialEfficacy outcome
In adults with inadequately controlled type 2 diabetes on lower-dose dulaglutide, switching to tirzepatide reduced weight at week 40 by 6.9 kg more than escalating dulaglutide.
In plain wordsIn adults with type 2 diabetes not controlled on dulaglutide, switching to tirzepatide led to more weight loss than raising the dulaglutide dose.
Peptide
Tirzepatide
Outcome
DecreaseWeight change from baseline at week 40
Study
n = 282
Comparator
Dulaglutide 4.5 mg or maximum tolerated dose
Analysis
Secondary
Outcome group
Body weight · Metabolic and weight
Studied dose
15 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Measurements
Weight change
−10.5 kg
tirzepatide
Weight change
−3.6 kg
dulaglutide
Estimated treatment difference
−6.9 kg
tirzepatide vs dulaglutide
Source sentences
Summary
Change from baseline in weight at week 40 was -10.5 kg (SE, 0.5) with tirzepatide and -3.6 kg (SE, 0.5) with dulaglutide (estimated treatment difference, -6.9 kg [CI, -8.3 to -5.5 kg; P < 0.001]).
2 context sentences(design, population, supporting numbers)
Summary · context
The key secondary end point was change from baseline in weight at week 40.
Summary · context
Adults with HbA_1c 7.0% or greater to 9.5% or less, stable body weight, body mass index of 25 kg/m² or greater, receiving a stable dose of dulaglutide (0.75 or 1.5 mg) for at least 6 months and 0 to 3 oral antihyperglycemic medications for at least 3 months.
Report a problemFND-4018367802
04HumanRandomized controlled trialEfficacy outcome
In adults with diabetes, dulaglutide escalation reduced weight less than switching to tirzepatide at week 40.
In plain wordsIn adults with diabetes, increasing dulaglutide reduced weight less than switching to tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseWeight change
Study
n = 282
Comparator
Tirzepatide 15 mg or maximum tolerated dose
Analysis
Secondary
Outcome group
Body weight · Metabolic and weight
Studied dose
4.5 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Measurements
Weight change
−3.6 kg
dulaglutide
Standard error
0.5 kg
dulaglutide weight change
Weight change
−10.5 kg
tirzepatide
Standard error
0.5 kg
tirzepatide weight change
Estimated treatment difference
−6.9 kg
tirzepatide versus dulaglutide
95% CI of estimated treatment difference
−8.3 to −5.5 kg
tirzepatide versus dulaglutide
Source sentences
Summary
Change from baseline in weight at week 40 was -10.5 kg (SE, 0.5) with tirzepatide and -3.6 kg (SE, 0.5) with dulaglutide (estimated treatment difference, -6.9 kg [CI, -8.3 to -5.5 kg; P < 0.001]).
2 context sentences(design, population, supporting numbers)
Summary · context
The key secondary end point was change from baseline in weight at week 40.
Summary · context
Escalation of dulaglutide to 4.5 mg or maximum tolerated dose (MTD) or switching to tirzepatide.
Report a problemFND-4018367806
05HumanRandomized controlled trialSafety outcome
In adults with type 2 diabetes, serious adverse events were reported by 7.2% of participants switched to tirzepatide and 7.0% of those escalated on dulaglutide.
In plain wordsIn adults with type 2 diabetes, serious side effects were reported by about 7% in both the tirzepatide and the dulaglutide groups.
Peptide
Tirzepatide
Outcome
Direction not reportedSerious adverse events
Study
n = 282
Comparator
Dulaglutide 4.5 mg or maximum tolerated dose
Outcome group
Adverse events · Whole body
Studied dose
15 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Measurements
Participants with serious adverse events
7.2%
tirzepatide
Participants with serious adverse events
7%
dulaglutide
Source sentences
Summary
Serious adverse events were reported by 10 (7.2%) tirzepatide and 10 (7.0%) dulaglutide participants.
1 context sentence(design, population, supporting numbers)
Summary · context
Adults with HbA_1c 7.0% or greater to 9.5% or less, stable body weight, body mass index of 25 kg/m² or greater, receiving a stable dose of dulaglutide (0.75 or 1.5 mg) for at least 6 months and 0 to 3 oral antihyperglycemic medications for at least 3 months.
Report a problemFND-4018367803
06HumanRandomized controlled trialSafety outcome
In adults with type 2 diabetes, the most common treatment-emergent adverse events were nausea and diarrhea.
In plain wordsIn adults with type 2 diabetes, the most common side effects in the trial were nausea and diarrhea.
Peptide
Tirzepatide
Outcome
Not applicableMost common treatment-emergent adverse events
Study
n = 282
Comparator
Dulaglutide 4.5 mg or maximum tolerated dose
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
15 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Source sentences
Summary
The most common treatment-emergent adverse events were nausea and diarrhea.
1 context sentence(design, population, supporting numbers)
Summary · context
Adults with HbA_1c 7.0% or greater to 9.5% or less, stable body weight, body mass index of 25 kg/m² or greater, receiving a stable dose of dulaglutide (0.75 or 1.5 mg) for at least 6 months and 0 to 3 oral antihyperglycemic medications for at least 3 months.
Report a problemFND-4018367804
07HumanRandomized controlled trialSafety outcome
In adults with diabetes, serious adverse events occurred in 10 dulaglutide participants, compared with 10 tirzepatide participants.
In plain wordsIn adults with diabetes, serious adverse events occurred in 10 people receiving dulaglutide and 10 receiving tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableSerious adverse events
Study
n = 282
Comparator
Tirzepatide 15 mg or maximum tolerated dose
Outcome group
Adverse events · Whole body
Studied dose
4.5 mg or maximum tolerated dose · 40 weeksAs given in this study (human).
Measurements
Serious adverse events
10 participants
dulaglutide
Serious adverse events
7%
dulaglutide
Serious adverse events
10 participants
tirzepatide
Serious adverse events
7.2%
tirzepatide
Source sentences
Summary
Serious adverse events were reported by 10 (7.2%) tirzepatide and 10 (7.0%) dulaglutide participants.
2 context sentences(design, population, supporting numbers)
Summary · context
A total of 282 adults were randomly assigned to tirzepatide (n = 139) or dulaglutide (n = 143).
Summary · context
Escalation of dulaglutide to 4.5 mg or maximum tolerated dose (MTD) or switching to tirzepatide.
Report a problemFND-4018367807

Studies that did not test the peptide alone1

In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Dulaglutide (Trulicity).

08HumanNot a test of Dulaglutide (Trulicity) aloneRandomized controlled trialSafety outcome
In adults with type 2 diabetes in the dulaglutide escalation versus tirzepatide trial, nausea and diarrhea were the most common treatment-emergent adverse events.
In plain wordsIn adults with diabetes, nausea and diarrhea were the most common side effects in the trial comparing dulaglutide escalation with tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
Not applicableMost common treatment-emergent adverse events
Study
n = 282
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Source sentences
Summary
The most common treatment-emergent adverse events were nausea and diarrhea.
1 context sentence(design, population, supporting numbers)
Summary · context
Escalation of dulaglutide to 4.5 mg or maximum tolerated dose (MTD) or switching to tirzepatide.
In this study, Dulaglutide (Trulicity) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Dulaglutide (Trulicity).
Report a problemFND-4018367808

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 4Results postedNCT05564039

A Study of Tirzepatide (LY3298176) in Adult Participants With Type 2 Diabetes Switching From Dulaglutide (SURPASS-SWITCH)

Eli Lilly and Companyn = 28230 Nov 2022 to 12 Aug 2024

Type 2 Diabetes

Trial page ClinicalTrials.govUpdated 3 Aug 2025

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Versions 4 to 8Current
28 Oct 2026, 02:03 UTC
The same notice was added 5 times, first on 22 Oct 2026, 02:26 UTC. The status did not change between them.
Study results updated
Version 3
21 Oct 2026, 18:59 UTC
Study data updated · source update from Europe PMC
Version 2
12 Oct 2026, 12:58 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC