Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes.

Nicholls SJ, Pavo I, Bhatt DL, Buse JB, Del Prato S, Kahn SE, Lincoff AM, McGuire DK, Miller D, Nauck MA, Nishiyama H, Nissen SE and 15 more

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Sattar N, Weerakkody G, Wiese RJ, Zinman B, Zoungas S, Basile J, Davies MJ, Giorgino F, Kellerer M, Ji L, Varkonyi T, Menon V, Broder JC, Herschtal A, D'Alessio D

The New England journal of medicine1 Dec 2025Cited by 84 (Europe PMC)

PMID41406444DOI10.1056/nejmoa2505928PepBankPUB-41406444

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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 study6

6 results from studies that gave the peptide. 6 results from people.

01HumanRandomized controlled trialEfficacy outcome
In adults with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was noninferior to dulaglutide for the primary composite end point, and superiority was not shown.
In plain wordsIn adults with type 2 diabetes and heart disease, tirzepatide was as good as dulaglutide for heart events. It was not shown to be better.
Peptide
Tirzepatide
Outcome
No significant changeComposite of cardiovascular death, myocardial infarction or stroke
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
up to 15 mg once weekly · subcutaneousAs given in this study (human).
Measurements
Hazard ratio
0.92 ratio
tirzepatide vs dulaglutide
Event proportion
12.2%
tirzepatide
Event proportion
13.1%
dulaglutide
Source sentences
Summary
A primary end-point event occurred in 801 patients (12.2%) in the tirzepatide group and 862 (13.1%) in the dulaglutide group (hazard ratio, 0.92; 95.3% confidence interval, 0.83 to 1.01; P = 0.003 for noninferiority; P = 0.09 for superiority).
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted an active-comparator-controlled, double-blind, noninferiority trial in which patients with type 2 diabetes and atherosclerotic cardiovascular disease were randomly assigned in a 1:1 ratio to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg), an…
Report a problemFND-4140644401
02HumanRandomized controlled trialEfficacy outcome
In patients with T2D and atherosclerotic cardiovascular disease, tirzepatide was noninferior but not superior to dulaglutide for the primary cardiovascular composite.
In plain wordsIn patients with diabetes and cardiovascular disease, tirzepatide was noninferior to dulaglutide for major cardiovascular events, without significant superiority.
Peptide
Dulaglutide (Trulicity)
Outcome
No significant changeCardiovascular death, myocardial infarction, or stroke composite
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
1.5 mg weekly · subcutaneousAs given in this study (human).
Measurements
Primary endpoint events
862 patients
dulaglutide
Primary endpoint incidence
13.1%
dulaglutide
Primary endpoint events
801 patients
tirzepatide
Primary endpoint incidence
12.2%
tirzepatide
Hazard ratio
0.92 ratio
tirzepatide versus dulaglutide
95.3% confidence interval of hazard ratio
0.83 to 1.01 ratio
tirzepatide versus dulaglutide
Source sentences
Summary
A primary end-point event occurred in 801 patients (12.2%) in the tirzepatide group and 862 (13.1%) in the dulaglutide group (hazard ratio, 0.92; 95.3% confidence interval, 0.83 to 1.01; P = 0.003 for noninferiority; P = 0.09 for superiority).
2 context sentences(design, population, supporting numbers)
Summary · context
The primary end point was a composite of death from cardiovascular causes, myocardial infarction, or stroke and was tested for noninferiority of tirzepatide to dulaglutide with a margin of 1.05 for the upper limit of the 95.3% confidence interval for the hazard ratio.
Summary · context
patients with type 2 diabetes and atherosclerotic cardiovascular disease were randomly assigned in a 1:1 ratio to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg)
Report a problemFND-4140644404
03HumanRandomized controlled trialSafety outcome
In adults with type 2 diabetes and atherosclerotic cardiovascular disease, the overall incidence of adverse events appeared similar with tirzepatide and dulaglutide.
In plain wordsIn adults with type 2 diabetes and heart disease, side effects overall seemed similar with tirzepatide and dulaglutide.
Peptide
Tirzepatide
Outcome
No significant changeOverall incidence of adverse events
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Adverse events · Whole body
Studied dose
up to 15 mg once weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
The incidence of adverse events appeared to be similar in the two groups, although more gastrointestinal adverse events were observed in the tirzepatide group.
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted an active-comparator-controlled, double-blind, noninferiority trial in which patients with type 2 diabetes and atherosclerotic cardiovascular disease were randomly assigned in a 1:1 ratio to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg), an…
Report a problemFND-4140644402
04HumanRandomized controlled trialSafety outcome
In adults with type 2 diabetes and atherosclerotic cardiovascular disease, more gastrointestinal adverse events were observed with tirzepatide than with dulaglutide.
In plain wordsIn adults with type 2 diabetes and heart disease, tirzepatide caused more stomach and gut side effects than dulaglutide.
Peptide
Tirzepatide
Outcome
IncreaseGastrointestinal adverse events
Study
n: not reported in source
Comparator
Dulaglutide 1.5 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
up to 15 mg once weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
The incidence of adverse events appeared to be similar in the two groups, although more gastrointestinal adverse events were observed in the tirzepatide group.
1 context sentence(design, population, supporting numbers)
Summary · context
We conducted an active-comparator-controlled, double-blind, noninferiority trial in which patients with type 2 diabetes and atherosclerotic cardiovascular disease were randomly assigned in a 1:1 ratio to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg), an…
Report a problemFND-4140644403
05HumanRandomized controlled trialSafety outcome
In patients with T2D and atherosclerotic cardiovascular disease, adverse event incidence appeared similar with dulaglutide and tirzepatide.
In plain wordsIn patients with diabetes and cardiovascular disease, overall adverse event rates appeared similar with dulaglutide and tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
No significant changeAdverse events
Study
n: not reported in source
Comparator
Tirzepatide up to 15 mg
Outcome group
Adverse events · Whole body
Studied dose
1.5 mg weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
The incidence of adverse events appeared to be similar in the two groups, although more gastrointestinal adverse events were observed in the tirzepatide group.
1 context sentence(design, population, supporting numbers)
Summary · context
patients with type 2 diabetes and atherosclerotic cardiovascular disease were randomly assigned in a 1:1 ratio to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg)
Report a problemFND-4140644405
06HumanRandomized controlled trialSafety outcome
In patients with T2D and atherosclerotic cardiovascular disease, gastrointestinal adverse events were less frequent with dulaglutide than tirzepatide.
In plain wordsIn patients with diabetes and cardiovascular disease, dulaglutide caused fewer digestive adverse events than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseGastrointestinal adverse events
Study
n: not reported in source
Comparator
Tirzepatide up to 15 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
1.5 mg weekly · subcutaneousAs given in this study (human).
Source sentences
Summary
The incidence of adverse events appeared to be similar in the two groups, although more gastrointestinal adverse events were observed in the tirzepatide group.
1 context sentence(design, population, supporting numbers)
Summary · context
patients with type 2 diabetes and atherosclerotic cardiovascular disease were randomly assigned in a 1:1 ratio to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg)
Report a problemFND-4140644406

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

Registered trials2

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

2 trials · 1 not yet recruiting · 1 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

Not yet recruitingPhase not statedNCT07567378

CARTIZ Registry: Cartilage, Arthropathy and Imaging Under Tirzepatide in Zone-stratified Cohorts - A Four-Institute Mexican Observational Registry

JULIO GRANADOS MONTIELn = 30est. May 2026 to est. May 2029

Psoriatic Arthritis · Osteoarthitis · Knee · Diabetes (DM) · Type 2 Diabetes Mellitus (T2DM) · Obesity (Disorder) · Insulin Resistance Syndrome · Metabolic Syndrome · Heart Failure · Preserved Ejection Fraction · Coronary Artery Disease · Atrial Fibrillation (AF) · Non Alcholic Fatty Liver Disease · Sarcopenia · Pericardium

Trial page ClinicalTrials.govUpdated 12 May 2026

CompletedPhase 3Results postedNCT04255433

A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes

Eli Lilly and Companyn = 13,29929 May 2020 to 12 Jun 2025

Type 2 Diabetes Mellitus

Trial page ClinicalTrials.govUpdated 8 Jul 2026

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