Comparative Effectiveness of Tirzepatide Versus Dulaglutide or Semaglutide on Major Cardiovascular Events in Type 2 Diabetes and Cardiovascular Disease: Insights From Two Target-Trial Emulations.

Ostrominski JW, Ortega-Montiel J, Wexler DJ, Everett BM, Cromer SJ, Byrne CF, Glynn RJ, Paik JM, Patorno E

Diabetes care1 May 2026Cited by 1 (Europe PMC)

PMID41778928PMCIDPMC13241951DOI10.2337/dc25-3063PepBankPUB-41778928

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

8 results from studies that gave the peptide. 8 results from people.

01HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, modified MACE rates were similar with tirzepatide and semaglutide initiation.
In plain wordsIn adults with diabetes and cardiovascular disease, major cardiovascular event rates were similar with tirzepatide and semaglutide.
Peptide
Tirzepatide
Outcome
No significant changeModified MACE versus semaglutide
Study
n = 50,532
Comparator
Semaglutide
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Incidence rate
23.7 per 1,000 person-years
tirzepatide initiators
Incidence rate
23.2 per 1,000 person-years
semaglutide initiators
Hazard ratio
1.03
tirzepatide versus semaglutide
Source sentences
Summary
Rates of modified MACE were similar among tirzepatide and semaglutide initiators (IR 23.7 vs. 23.2, respectively; HR 1.03 [95% CI 0.90-1.17]).
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892807
02HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, modified MACE rates were similar with semaglutide and tirzepatide initiation.
In plain wordsIn adults with diabetes and cardiovascular disease, major cardiovascular event rates were similar with semaglutide and tirzepatide.
Peptide
Semaglutide
Outcome
No significant changeModified MACE versus tirzepatide
Study
n = 50,532
Comparator
Tirzepatide
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Incidence rate
23.7 per 1,000 person-years
tirzepatide initiators
Incidence rate
23.2 per 1,000 person-years
semaglutide initiators
Hazard ratio
1.03
tirzepatide versus semaglutide
Source sentences
Summary
Rates of modified MACE were similar among tirzepatide and semaglutide initiators (IR 23.7 vs. 23.2, respectively; HR 1.03 [95% CI 0.90-1.17]).
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892808
03HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, tirzepatide initiation was linked to lower modified MACE rates than dulaglutide initiation.
In plain wordsIn adults with diabetes and cardiovascular disease, tirzepatide was linked to fewer major cardiovascular events than dulaglutide.
Peptide
Tirzepatide
Outcome
DecreaseModified MACE versus dulaglutide
Study
n = 18,466
Comparator
Dulaglutide
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Incidence rate
31.3 per 1,000 person-years
tirzepatide initiators
Incidence rate
39.4 per 1,000 person-years
dulaglutide initiators
Hazard ratio
0.8
tirzepatide versus dulaglutide
Source sentences
Summary
Tirzepatide initiators experienced a lower rate of modified MACE versus dulaglutide initiators (IR 31.3 vs. 39.4, respectively; HR 0.80 [95% CI 0.65-0.99])
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892801
04HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, dulaglutide initiation was linked to higher modified MACE rates than tirzepatide initiation.
In plain wordsIn adults with diabetes and cardiovascular disease, dulaglutide was linked to more major cardiovascular events than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseModified MACE versus tirzepatide
Study
n = 18,466
Comparator
Tirzepatide
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Incidence rate
31.3 per 1,000 person-years
tirzepatide initiators
Incidence rate
39.4 per 1,000 person-years
dulaglutide initiators
Hazard ratio
0.8
tirzepatide versus dulaglutide
Source sentences
Summary
Tirzepatide initiators experienced a lower rate of modified MACE versus dulaglutide initiators (IR 31.3 vs. 39.4, respectively; HR 0.80 [95% CI 0.65-0.99])
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892802
05HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, tirzepatide initiation was linked to lower all-cause mortality than dulaglutide initiation.
In plain wordsIn adults with diabetes and cardiovascular disease, tirzepatide was linked to fewer deaths than dulaglutide.
Peptide
Tirzepatide
Outcome
DecreaseAll-cause mortality versus dulaglutide
Study
n = 18,466
Comparator
Dulaglutide
Outcome group
Mortality · Whole body
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Hazard ratio
0.6
versus dulaglutide
Source sentences
Summary
which seemed to be driven by lower all-cause mortality among tirzepatide versus dulaglutide initiators (HR 0.60 [95% CI 0.43-0.83]).
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892803
06HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, dulaglutide initiation was linked to higher all-cause mortality than tirzepatide initiation.
In plain wordsIn adults with diabetes and cardiovascular disease, dulaglutide was linked to more deaths than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseAll-cause mortality versus tirzepatide
Study
n = 18,466
Comparator
Tirzepatide
Outcome group
Mortality · Whole body
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Measurements
Hazard ratio
0.6
tirzepatide versus dulaglutide
Source sentences
Summary
which seemed to be driven by lower all-cause mortality among tirzepatide versus dulaglutide initiators (HR 0.60 [95% CI 0.43-0.83]).
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892804
07HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, post hoc analysis linked tirzepatide to fewer pneumonia-related hospitalizations than dulaglutide.
In plain wordsIn adults with diabetes and cardiovascular disease, tirzepatide was linked to fewer pneumonia hospitalizations than dulaglutide.
Peptide
Tirzepatide
Outcome
DecreasePneumonia-related hospitalization
Study
n = 18,466
Comparator
Dulaglutide
Outcome group
Adverse events · Respiratory
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Source sentences
Summary
In post hoc analyses, tirzepatide was associated with lower rates of pneumonia-related hospitalization when compared with dulaglutide.
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892805
08HumanObservational studyEfficacy outcome
In adults with T2D and ASCVD, post hoc analysis linked dulaglutide to more pneumonia-related hospitalizations than tirzepatide.
In plain wordsIn adults with diabetes and cardiovascular disease, dulaglutide was linked to more pneumonia hospitalizations than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreasePneumonia-related hospitalization
Study
n = 18,466
Comparator
Tirzepatide
Outcome group
Adverse events · Respiratory
Studied dose
Dose not stated · subcutaneousAs given in this study (human).
Source sentences
Summary
In post hoc analyses, tirzepatide was associated with lower rates of pneumonia-related hospitalization when compared with dulaglutide.
1 context sentence(design, population, supporting numbers)
Summary · context
Two target trial emulations included commercially insured adults (June 2022-December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide.
Report a problemFND-4177892806

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 · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase not statedNCT06779929

Comparative Study of Tirzepatide Versus Dulaglutide (SURPASS CVOT) or Semaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes

Brigham and Women's Hospitaln = 70,0001 Nov 2024 to 1 Mar 2026

Type 2 Diabetes

Trial page ClinicalTrials.govUpdated 18 Sept 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.

Version 4Current
22 Oct 2026, 02:25 UTC
Study results updated
Versions 2 to 3
21 Oct 2026, 18:59 UTC
The same notice was added 2 times, first on 9 Oct 2026, 03:07 UTC. The status did not change between them.
Study data updated · source update from Europe PMC
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC