Tirzepatide demonstrates cardiovascular protection in head-to-head trial with dulaglutide
Eli Lilly and Company announced results today from the SURPASS-CVOT trial, a head-to-head cardiovascular outcomes trial comparing two tirzepatide (Mounjaro) with dulaglutide (Trulicity) in adults with type 2 diabetes and established atherosclerotic cardiovascular disease.
This Phase 3 trial showed tirzepatide, a GIP/GLP-1 dual receptor agonist, met the primary objective of non-inferiority versus dulaglutide, a GLP-1 receptor agonist, with an 8% lower rate of major adverse cardiovascular events (MACE) that included cardiovascular death, heart attack or stroke, while delivering greater reductions in A1C and weight.
Tirzepatide was associated with a 16% lower rate of all-cause death compared to dulaglutide, suggesting more comprehensive health benefits, Eli Lilly said in a statement.
“These drugs help with glycemic control, weight loss, renal protection, and we’re now seeing solid cardiovascular benefits. That’s a big deal," Howard Weintraub, MD, a preventive cardiologist at NYU Langone Health who has been closely following the trial said in a statement. “This study validates that GLP-1s are cardioprotective. Whether you use Ozempic, Mounjaro, or others, they work. But Mounjaro offers more bang in terms of weight and glycemia."
The trial adds additional positive data for the use of GLP-1 receptor agonists in preventive cardiology, especially for patients who are obese and have type 2 diabetes, which these drugs were originally designed to treat. Interest in these agents has seen a rapid rise at cardiology conferences the past few years. Many experts see these drugs as a paradigm shift in preventive cardiac care, similar to the change seen with the introduction of statins more than 30 years ago.
The SURPASS-CVOT trial enrolled more than 13,000 participants across 30 countries and lasted more than four and a half years, making it the largest and longest study of tirzepatide to date. A pre-specified indirect comparison analysis of matched patient-level data from the REWIND and SURPASS-CVOT studies found tirzepatide reduced the risk of MACE by 28%, and all-cause mortality by 39% compared to a placebo. In another key analysis of patients with high or very-high risk of chronic kidney disease, tirzepatide slowed eGFR decline by 3.54 mL/min/1.73 m2 at 36 months vs. dulaglutide.
"Cardiovascular disease remains the leading cause of death among people living with type 2 diabetes," explained Kenneth Custer, PhD, executive vice president and president, Lilly Cardiometabolic Health, in a statement. "The SURPASS-CVOT results show that Mounjaro preserved the cardioprotective benefit of Trulicity, a GLP-1 receptor agonist, while providing additional benefits, including greater kidney protection and a reduced overall risk of death. These findings strengthen the case for Mounjaro as a potential front-line treatment for people with type 2 diabetes and cardiovascular disease."
While this and other trials continue to show the cardio-protective effects of tirzepatide, cost has been a major barrier for many patients. "The challenge is access. We need to make sure patients can get on and stay on the best option for them,” Weintraub explained.
Detailed results from the SURPASS-CVOT trial will be presented at the European Association for the Study of Diabetes (EASD) 2025 annual meeting 2025 in September. Lilly said it plans to submit the relevant data to global regulatory authorities by the end of this year to expand the drug's indications.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]