Mounjaro vs. Trulicity: Eli Lilly’s Landmark Diabetes Study Reveals Promising Results

Mounjaro vs. Trulicity: Eli Lilly’s Landmark Diabetes Study Reveals Promising Results

Eli Lilly just dropped a major update in the battle against cardiovascular complications in type 2 diabetes. The company revealed topline results from its SURPASS-CVOT trial, directly comparing two powerful incretin-based therapies: Mounjaro (tirzepatide) and Trulicity (dulaglutide).

Here are some quick facts:

  • A head-to-head phase 3 cardiovascular outcomes trial.
  • Over 13,000 participants enrolled across 30 countries.
  • Four and a half years in duration.
  • Targeted adults with type 2 diabetes and atherosclerotic cardiovascular disease.

Mounjaro Hits the Mark

Mounjaro matched Trulicity in preventing major adverse cardiovascular events (MACE-3), which include cardiovascular death, heart attack, or stroke.

Key Outcomes:

  • Met the non-inferiority benchmark (HR: 0.92; 95.3% CI: 0.83–1.01).
  • Delivered 8% lower risk of MACE-3 vs. Trulicity.
  • Reduced all-cause mortality by 16% (HR: 0.84; 95.0% CI: 0.75–0.94).

Additional Clinical Benefits of Mounjaro

Beyond MACE-3, Mounjaro offered significant advantages:

  • Improved A1C levels and weight reduction.
  • Better renal function outcomes.
  • Slowed kidney function decline by 3.54 mL/min/1.73 m² at 36 months vs. Trulicity.
  • Lowered risk of death from all causes.

Indirect Comparison vs. Placebo (Pre-Specified Analysis):

  • 28% MACE-3 risk reduction (HR: 0.72; CI: 0.55–0.94).
  • 39% reduction in all-cause mortality (HR: 0.61; CI: 0.45–0.82).

What This Means for Patients

“These findings strengthen the case for Mounjaro as a potential front-line treatment,”

  • Dr. Kenneth Custer, EVP and President of Lilly Cardiometabolic Health.
  • Cardiovascular disease remains the top killer for people with type 2 diabetes.
  • Mounjaro may offer cardioprotective benefits + kidney protection + longer life.
  • Potential to redefine first-line treatment options in high-risk diabetic patients.

Safety and Tolerability

The side-effect profiles for both drugs were consistent with prior data.

  • Most common side effects: Mild-to-moderate GI symptoms.
  • Discontinuation due to adverse events:
    - 13.3% for Mounjaro.
    - 10.2% for Trulicity.

Trial Design Snapshot

SURPASS-CVOT:

  • Randomized, double-blind, event-driven phase 3 trial.
  • Compared MTD of Mounjaro (5/10/15 mg) with Trulicity (1.5 mg).
  • Dosing escalated every 4 weeks until MTD was reached.
  • Conducted across 640 sites in 30 countries.
  • Median follow-up of 4 years.

REWIND (2019):

  • Compared Trulicity 1.5 mg vs. placebo.
  • Included adults with or without existing cardiovascular disease.
  • Enrolled 9,901 patients from 24 countries.
  • Primary outcome: MACE-3; Secondary: renal, retinal, hospitalization, and mortality metrics.

What Is Tirzepatide?

Tirzepatide is a dual GIP and GLP-1 receptor agonist. It mimics two natural incretin hormones to control:

  • Blood sugar
  • Appetite
  • Weight
  • Metabolism

Tirzepatide also shows promising effects on kidney and heart health, with ongoing studies in:

  • Chronic Kidney Disease (CKD)
  • Obesity-related morbidity/mortality
  • Obstructive sleep apnoea (Zepbound label)

Regulatory Roadmap Ahead

  • Full SURPASS-CVOT results will be shared at EASD 2025 in September.
  • Eli Lilly will submit the data to global regulatory bodies by year-end.

Bottom Line

Mounjaro isn’t just matching Trulicity—it may be outpacing it on multiple fronts. From heart protection to kidney health and mortality reduction, it’s a serious contender for redefining type 2 diabetes care.

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