Tirzepatide Matches Dulaglutide in Large CV Outcomes Trial: SURPASS-CVOT

Treating patients who have type 2 diabetes and atherosclerotic cardiovascular disease with tirzepatide (Mounjaro) results in MACE rates similar to those seen with the older diabetes drug dulaglutide (Trulicity), according to top-line results announced today by drugmaker Eli Lilly.

In SURPASS-CVOT, a large cardiovascular outcomes study of more than 13,200 patients, the use of tirzepatide, which is a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) dual receptor agonist, matched the GLP-1 agonist dulaglutide when it came to the primary endpoint of cardiovascular mortality, MI, or stroke.

MACE were 8% less common with tirzepatide (HR 0.92; 95% CI 0.83-1.01), which met the prespecified criteria for noninferiority. The rates of all-cause mortality, improvements in kidney function, and reductions in HbA1c were significantly better with tirzepatide, although these comparisons were not adjusted for potential type 1 error.

Dulaglutide was selected as the comparator based on results from REWIND. In that trial of patients with type 2 diabetes and preexisting CVD (or risk factors), dulaglutide significantly lowered the risk of cardiovascular mortality, MI, or stroke compared with placebo.

Full results of SURPASS-CVOT are slated for presentation at the European Association for the Study of Diabetes annual meeting in September 2025 and will be published in a journal, according to Eli Lilly. 

Tirzepatide is currently being tested in another large, cardiovascular outcomes study: SURMOUNT-MMO. In that trial, investigators are testing whether the drug can reduce the risk of all-cause mortality, nonfatal MI, nonfatal stroke, coronary revascularization, or heart failure events in patients with overweight and established cardiovascular disease (or multiple risk factors based on age). Results of SURMOUNT-MMO aren’t expected until 2027.