DULAGLUTIDE

Summary

Dulaglutide is a once-weekly injectable GLP-1 receptor agonist used for glycemic control in type 2 diabetes, and it is an FDA-approved prescription medicine ^[1,2]. In the large double-blind, placebo-controlled REWIND cardiovascular outcomes trial, dulaglutide reduced a composite cardiovascular endpoint (HR 0.88, 95% CI 0.79–0.99; p=0.026), though all-cause mortality did not differ significantly between groups ^[1]. Comparative phase 3 trials show it improves glycemic control and bodyweight, while head-to-head data found semaglutide superior to dulaglutide at low and high doses for these outcomes ^[2], and tirzepatide was non-inferior to dulaglutide for major adverse cardiovascular events in patients with established atherosclerotic disease ^[3]. The most consistent adverse effects are gastrointestinal, reported far more often with dulaglutide than placebo (47.4% vs 34.1%) and a leading reason for discontinuation ^[1,2]. Overall the human evidence is strong, derived from multiple large randomized controlled trials.

Sources

1. 1. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial Lancet (London, England), 2019.
2. 2. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial The lancet. Diabetes & endocrinology, 2018.
3. 3. Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes The New England journal of medicine, 2025.

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