ACP: Switching From Dulaglutide to Tirzepatide Improves HbA1c Reduction in T2DM
By Elana Gotkine HealthDay Reporter
FRIDAY, April 4, 2025 -- For patients with inadequately controlled type 2 diabetes receiving dulaglutide, switching to tirzepatide is associated with additional hemoglobin A1c (HbA1c) reduction and weight loss compared with escalating treatment with dulaglutide, according to a study published online April 4 in the Annals of Internal Medicine to coincide with the Internal Medicine Meeting, the annual meeting of the American College of Physicians, held from April 3 to 5 in New Orleans.
Liana K. Billings, M.D., from the Pritzker School of Medicine at the University of Chicago, and colleagues conducted a multicenter, randomized, phase 4 trial to compare the efficacy and safety of escalation of dulaglutide dose versus switching to tirzepatide in inadequately controlled type 2 diabetes. A total of 828 adults with HbA1c 7.0 percent or greater to 9.5 percent or less, stable body weight, and body mass index of 25 kg/m2 or greater receiving a stable dose of dulaglutide (0.75 or 1.5 mg) for at least six months were randomly assigned to tirzepatide or escalation of dulaglutide (139 and 143, respectively).
The researchers found that at week 40, the change from baseline in HbA1c was −1.44 and −0.67 percent with tirzepatide and dulaglutide escalation to 4.5 mg or maximum tolerated dose, respectively. The change from baseline in weight at week 40 was −10.5 and −3.6 kg with tirzepatide and dulaglutide, respectively. Overall, 7.2 and 7.0 percent of tirzepatide- and dulaglutide-treated patients, respectively, had serious adverse events. Nausea and diarrhea were the most common treatment-emergent adverse events reported.
"Once-weekly treatment with tirzepatide resulted in significantly greater HbA1c and weight reductions compared with continuing and escalating dulaglutide treatment," the authors write.
The study was funded by Eli Lilly, the manufacturer of tirzepatide.
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Posted April 2025
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