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
Authors' conclusion
Among adults with T2D and ASCVD in routine care, tirzepatide was associated with a lower risk of modified MACE when compared with dulaglutide, driven by reduction in all-cause mortality. Risks of modified MACE seemed similar with tirzepatide and semaglutide.
Study context
- Population
- Commercially insured adults with T2D and atherosclerotic CVD initiating subcutaneous tirzepatide, dulaglutide or semaglutide (June 2022–December 2024)9,233 and 25,266 matched pairs
- Exposure
- Tirzepatide vs dulaglutide; tirzepatide vs semaglutide
- Outcome
- Modified major adverse cardiovascular events (MACE): composite of nonfatal MI, nonfatal stroke and all-cause death
Methodological detailscomparative effectiveness cohort study, propensity score matched one to one, new-user design, commercially insured
- Comparative effectiveness cohort study
- Propensity score matched one to one
- New-user design
- Commercially insured
Main finding
As reported in the abstract
Modified MACE (IR per 1,000 person-years)
Hazard ratio (95% CI)
Tirzepatide vs DulaglutideIR 31.3vs 39.4; 9,233 matched pairs
0.80(0.65–0.99)
Tirzepatide vs SemaglutideIR 23.7vs 23.2; 25,266 matched pairs
1.03(0.90–1.17)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause mortalityTirzepatidevs Dulaglutide | 0.60 (0.43–0.83) | |
| 0.512Hazard ratio (log scale) |
Pneumonia-related hospitalization
- Lower rates with tirzepatide vs dulaglutide
- Post hoc analyses
Original publication
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. Diabetes Care. Published 4 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →