Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes
Nicholls SJ, Pavo I, Bhatt DL, et al. New England Journal of Medicine 2025;393:2409-2420.
What it found
In people with type 2 diabetes and atherosclerotic cardiovascular disease, cardiovascular death, heart attack or stroke occurred in 12.2% on tirzepatide vs 13.1% on dulaglutide (hazard ratio 0.92). Tirzepatide met the goal of being no worse than dulaglutide, but was not shown to be better. Gastrointestinal side effects were more frequent with tirzepatide.
Limitations
Compared with an active drug that already lowers cardiovascular risk, not with placebo, so it cannot give the size of benefit vs no treatment. Superiority was not shown.
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