Diabetes complications

Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes

N Engl J MedPublished Randomised controlled trial

Primary resultResult — go to the resultHazard ratio 0.92 95.3% CI 0.83–1.01

Authors' conclusion

Among patients with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was noninferior to dulaglutide with respect to a composite of death from cardiovascular causes, myocardial infarction, or stroke.

Study context

Population
Patients with T2DM and atherosclerotic CVD134 excluded
Participants
13,299 patients
Comparison
Tirzepatide vs dulaglutide
  • Tirzepatiden = 6,586
  • Dulaglutiden = 6,579reference
Primary endpoint
Composite of:
  • CV death
  • MI
  • Stroke
Methodological detailsactive-comparator-controlled, double-blind, noninferiority
  • Active-comparator-controlled
  • Double-blind
  • Noninferiority

Primary result

As reported in the abstract

Hazard ratio

0.92

95.3% CI 0.83–1.01

P = 0.003 for noninferiority

Events by treatment group

Tirzepatidevs Dulaglutide
HR 0.92 (95.3% CI 0.83–1.01); P = 0.003 for noninferiority

Safety

Incidence of adverse events appeared similar in the two groups; more gastrointestinal adverse events with tirzepatide

Original publication

Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes. N Engl J Med. Published 18 December 2025. doi:10.1056/nejmoa2505928

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