A comparison of the effects of tirzepatide and dulaglutide on major kidney events in people with type 2 diabetes: pre-specified exploratory analyses of the SURPASS-CVOT trial
Primary result · Primary composite kidney outcome, overall populationResult — go to the resultHazard ratio 0.77 95% CI 0.68–0.88Authors' conclusion
Among people with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was associated with a reduced risk of major kidney events compared with dulaglutide, primarily driven by a reduction in new-onset macroalbuminuria in people with low-to-moderate-risk chronic kidney disease, and slowed decline in kidney function in people with high-risk chronic kidney disease.
Study context
- Population
- Adults aged ≥40 years with T2D and atherosclerotic CVD, HbA1c 7%–10.5%, BMI ≥25 kg/m²; 640 sites in 30 countries134 randomised in error excluded
- Participants
- 13,299 adults
- Comparison
- Tirzepatide vs dulaglutide
- Tirzepatiden = 6,586
- Dulaglutiden = 6,579reference
- Primary endpoint
- Primary composite kidney outcome:
- Time to first persistent macroalbuminuria
- Persistent eGFR reduction ≥50%
- End-stage kidney disease (eGFR <15 mL/min per 1.73 m² or chronic kidney replacement therapy)
- Death from kidney disease
- Follow-up
- Median 4.0 (IQR 3.7-4.4) years
Methodological detailsactive comparator-controlled, double-blind, multicentre (640 sites, 30 countries), 1:1 allocation, Enrolled May 29, 2020 – June 27, 2022; 16 979 screened, 13 299 randomised (2948 with high-risk CKD)
- Active comparator-controlled
- Double-blind
- Multicentre (640 sites, 30 countries)
- 1:1 allocation
- Enrolled May 29, 2020 – June 27, 2022; 16 979 screened, 13 299 randomised (2948 with high-risk CKD)
Primary result
As reported in the abstract
Primary composite kidney outcome, overall population · median follow-up 4.0 years
Hazard ratio
0.77
95% CI 0.68–0.88
P = 0.0002
Events by treatment group
Tirzepatidevs Dulaglutide
HR 0.77 (95% CI 0.68–0.88); P = 0.0002
Further findings
| Outcome | Tirzepatide | Dulaglutide | HR | P value | |
|---|---|---|---|---|---|
| Primary composite kidney outcome, low-to-moderate-risk CKD | 4.0% | 5.6% | 0.70 (CI 0.58–0.84) | P = 0.0001 | |
| Primary composite kidney outcome, high-risk CKD | 12.2% | 14.5% | 0.79 (95% CI 0.64–0.96) | P = 0.018 | |
| 0.512Hazard ratio (log scale) |
| Outcome | Between-group difference, mL/min per 1.73 m² | P value | |
|---|---|---|---|
| Annual rate of eGFR decline, overall population (lower with tirzepatide) | 0.29 (95% CI 0.17–0.41) | P < 0.0001 | |
| Annual rate of eGFR decline, high-risk CKD (lower with tirzepatide) | 0.93 (CI 0.65–1.22) | P < 0.0001 | |
| −0.500.511.5Difference, mL/min per 1.73 m² (linear scale) |
Primary composite kidney outcome, low-to-moderate-risk CKD
- Primarily driven by lower rate of new-onset persistent macroalbuminuria
Primary composite kidney outcome, high-risk CKD
- Primarily driven by lower rate of estimated glomerular filtration rate (eGFR) decline
Other subgroups
- Observations were consistent in all other subgroups examined
Safety
Gastrointestinal adverse events
- Nausea, vomiting and diarrhoea were all more common with tirzepatide than dulaglutide
Original publication
A comparison of the effects of tirzepatide and dulaglutide on major kidney events in people with type 2 diabetes: pre-specified exploratory analyses of the SURPASS-CVOT trial. Lancet Diabetes Endocrinol. Published 11 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →