Tirzepatide noninferior to dulaglutide for CV outcomes in type 2 diabetes

Tirzepatide is noninferior to dulaglutide with respect to a composite of death from cardiovascular (CV) causes, myocardial infarction, or stroke among patients with type 2 diabetes and atherosclerotic CV disease, according to a study published in the Dec. 18/25 issue of the New England Journal of Medicine.

Stephen J. Nicholls, M.B., B.S., Ph.D., from Monash University in Australia, and colleagues conducted an active-comparator-controlled, noninferiority trial involving adults with type 2 diabetes and atherosclerotic CV disease. Participants were randomly assigned to receive a weekly subcutaneous injection of tirzepatide (up to 15 mg) or dulaglutide (1.5 mg) in a 1:1 ratio (6,586 and 6,579, respectively).

The researchers found that a primary end point event (composite of death from CV causes, myocardial infarction, or stroke) occurred in 12.2% and 13.1% in the tirzepatide and dulaglutide groups, respectively (hazard ratio, 0.92; 95.3% confidence interval, 0.83 to 1.01; P = 0.003 for noninferiority; P = 0.09 for superiority). The two groups had a similar incidence of adverse events; more gastrointestinal adverse events occurred in the tirzepatide group.

“I would consider it a big breakthrough, because not only can we use tirzepatide now for weight loss, but hopefully it can be more widely used in patients who have cardiovascular disease. And that’s important for us cardiologists, because when patients lose weight, they are improving their overall heart health,” Supreeti Behuria, M.D., from Staten Island University Hospital and Northwell Health, who was not involved in the study, said in a statement.

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