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 - Pub
8 hours ago
- #GLP-1 receptor agonists
- #cardiovascular outcomes
- #type 2 diabetes
- Comparative effectiveness study of tirzepatide versus dulaglutide or semaglutide on major cardiovascular events in type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD).
- Two target trial emulations included commercially insured adults with T2D and ASCVD initiating tirzepatide, dulaglutide, or semaglutide (June 2022-December 2024).
- Primary outcome: modified major adverse cardiovascular events (MACE) - composite of nonfatal myocardial infarction, nonfatal stroke, and all-cause death.
- Tirzepatide showed lower MACE rates vs. dulaglutide (HR 0.80, 95% CI 0.65-0.99), driven by reduced all-cause mortality (HR 0.60, 95% CI 0.43-0.83).
- Tirzepatide also associated with lower pneumonia-related hospitalization rates vs. dulaglutide in post hoc analyses.
- No significant difference in MACE rates between tirzepatide and semaglutide (HR 1.03, 95% CI 0.90-1.17).
- Conclusion: Tirzepatide may offer cardiovascular benefits over dulaglutide but similar outcomes to semaglutide in T2D and ASCVD patients.