The largest and longest tirzepatide study to date just confirmed that Eli Lilly’s Mounjaro has surpassed its older GLP-1, Trulicity, in practically every way, with significant gains when it comes to cardiovascular benefits.
- Dual GIP/GLP-1 receptor agonists like tirzepatide target two incretin pathways simultaneously, potentially offering advantages over single GLP-1 agonists.
- The REWIND trial studies already established Trulicity’s definitive CV benefits.
- This represents the first head-to-head comparison between incretin therapies in a cardiovascular outcomes trial.
The SURPASS-CVOT study represents the most comprehensive incretin analysis to date, comparing MACE rates in 13k T2D patients with ASCVD on either Mounjaro or Trulicity over a four year follow-up, finding that…
- MACE risk was 8% lower with Mounjaro.
- Mounjaro achieved non-inferiority per the study’s statistical cutoff.
Beyond meeting the study’s primary MACE endpoint, Mounjaro also demonstrated significant advantages across several secondary outcomes at 36 months, including…
- All-cause mortality reduced by 16%.
- Slowed kidney function decline by 3.54 mL/min/1.73 m² in high risk CKD patients.
- Superior A1C reduction (1.73% vs 0.90%).
- Greater weight loss (12.06% vs 4.95%).
Pre-specified indirect analyses of the study also suggest Mounjaro’s benefits may extend beyond existing GLP-1 therapies when compared to placebo controls.
- Indirect comparison to REWIND placebo data showed 28% MACE reduction.
- All-cause mortality reduction versus placebo reached 39%.
The Takeaway
SURPASS-CVOT could be a watershed moment for diabetes management, providing the first head-to-head evidence that dual incretin receptor activation helps protect the heart while delivering clinically meaningful advantages in mortality and kidney preservation. If nothing else, it asserts Mounjarno is a significant improvement over Lilly’s older Trulicity.
