Dulaglutide

“New initiation of any GLP-1 RA (liraglutide, semaglutide, dulaglutide, or exenatide)”

Glucagon-Like Peptide-1 Receptor Agonists and Cardiovascular Outcomes in Patients With Atherosclerotic Cardiovascular Disease and Obesity Without Diabetes. · Abstract

“Molecule type: Protein”

DULAGLUTIDE · Molecule identity

“Component 1: HGEGTFTSDVSSYLEEQAAKEFIAWLVKGGGGGGGSGGGGSGGGGSAESKYGPPCPPCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSQEDPEVQFNWYVDGVEVHNAKTKPREEQFNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKGLPSSIEKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQEGNVFSCSVMHEALHNHYTQKSLSLSLG”

DULAGLUTIDE · Sequence

“Subcutaneous dulaglutide (Trulicity®) is a once-weekly glucagon-like peptide-1 receptor agonist”

Dulaglutide: A Review in Type 2 Diabetes. · Abstract

“Primary research examining the association between GLP-1 RAs (i.e., dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide, tirzepatide) and suicidality were included for analysis.”

Association of Glucagon-Like Peptide-1 Receptor Agonists and Suicidality: A Systematic Review. · METHODS

“Dulaglutide (DU) is a once weekly glucagon-like peptide-1 receptor agonist (GLP-1 RA) approved for the treatment of type 2 diabetes mellitus (T2DM).”

Efficacy and safety of dulaglutide in the treatment of type 2 diabetes: a comprehensive review of the dulaglutide clinical data focusing on the AWARD phase 3 clinical trial program. · Abstract

“The glucagon-like peptide-1 receptor agonist (GLP-1 RA) class is rapidly expanding, with dulaglutide (Trulicity™) as a once-weekly agent recently approved.”

Dulaglutide: an evidence-based review of its potential in the treatment of type 2 diabetes. · INTRODUCTION

“Once-weekly treatment with dulaglutide, a glucagon-like peptide-1 receptor agonist, may have efficacy with regard to glycemic control in youths with type 2 diabetes.”

Once-Weekly Dulaglutide for the Treatment of Youths with Type 2 Diabetes. · Abstract

“As the half-life is short, both short-acting, exendin-4 (Ex4) and long-acting, liraglutide and dulaglutide, GLP-1 receptor (GLP-1R) agonists have been developed”

The glucagon-like peptide-1 receptor agonist, Ex4, reduces intromission in sexually experienced male mice. · Abstract

“Dulaglutide is a glucagon-like peptide 1 receptor (GLP-1R) agonist.”

Contractile effects of dulaglutide in the human atrium. · Abstract

“GLP-1 receptor agonists dulaglutide, exenatide, liraglutide, or semaglutide.”

Comparison of Specific Glucagon-Like Peptide-1 Receptor Agonists on Kidney Outcomes Among Patients With Type 2 Diabetes. · EXPOSURE

“Trulicity contains the active substance dulaglutide.”

Trulicity | European Medicines Agency (EMA) · Overview

“We selected dulaglutide, a GLP-1 analog fused to an IgG4 Fc moiety, as a model Fc-fusion protein.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“Dulaglutide consists of 2 GLP-1 analogues that have been modified to make it a long-acting, once-weekly agent.”

Dulaglutide: the newest GLP-1 receptor agonist for the management of type 2 diabetes. · DATA SYNTHESIS

“We produced dulaglutide-DNP, featuring a cyclic DNP peptide fused to the C-terminus of each Fc chain, in Chinese hamster ovary cells.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“Among 8869 matched sets of GLP-1RA (76.6% semaglutide, 15.2% dulaglutide, 7.9% liraglutide, and 0.3% exenatide)”

Comparative Effectiveness of Glucagon-like Peptide-1 Receptor Agonists Versus Oral Agents for Insulin Discontinuation in Type 2 Diabetes : A Target Trial Emulation. · RESULTS

“Dulaglutide (LY2189265) is a GLP-1(7-37) analogue fused by a linker to a modified immunoglobulin G.”

Contractile effects of dulaglutide in the human atrium. · Abstract

“Name: dulaglutide Ligand ID: 7638 Type: Peptide INN: dulaglutide”

dulaglutide · Identity and approval

“Dulaglutide (Trulicity™) is a once-weekly subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist produced by recombinant DNA technology”

Dulaglutide: A Review in Type 2 Diabetes. · Abstract

“To review the pharmacology, pharmacokinetics, safety, and efficacy of the glucagon-like peptide-1 receptor agonist (GLP-1 RA), dulaglutide, in the treatment of type 2 diabetes mellitus (T2D).”

Dulaglutide: the newest GLP-1 receptor agonist for the management of type 2 diabetes. · OBJECTIVE

“We tested the hypothesis that dulaglutide directly increased force of contraction in the human heart via GLP-1R. To this end, we conducted contraction experiments in paced (1 Hz) isolated human right atrial muscle preparations (HAP).”

Contractile effects of dulaglutide in the human atrium. · Abstract

“Using medication-specific dates, substances were classified as baseline (before index) or subsequently recorded (on or after index), and within-patient change as a lower count, no change, or a higher count.”

Changes in recorded background glucose-lowering therapy after initiation of a GLP-1 receptor agonist or dual GIP/GLP-1 receptor agonist in adults with type 2 diabetes. · METHODS

“FDA Adverse Event Reporting System (FAERS) data from 2021Q1 through 2026Q1 were processed using deleted-case exclusion, latest-case-version retention, and case-product deduplication with analysis at the GLP-1 primary-suspect case-product level. Primary-suspect records for semaglutide, tirzepatide, dulaglutide, liraglutide, exenatide, and lixisenatide were analysed”

Postmarketing Safety Signals and Medication-Use Risks of GLP-1-Based Therapies in Diabetes and Obesity: A Multi-Source Pharmacovigilance and Regulatory Evidence-Mapping Study. · MATERIALS AND METHODS

“and promoting satiety.”

Dulaglutide: the newest GLP-1 receptor agonist for the management of type 2 diabetes. · DATA SYNTHESIS

“Dulaglutide activates the GLP-1 receptor, a membrane-bound cell-surface receptor coupled to adenylyl cyclase in pancreatic beta cells. Dulaglutide increases intracellular cyclic AMP (cAMP) in beta cells leading to glucose-dependent insulin release. Dulaglutide also decreases glucagon secretion and slows gastric emptying.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 12.1 Mechanism of Action

“by stimulating insulin secretion and suppressing glucagon in a glucose-dependent manner”

Dulaglutide: the newest GLP-1 receptor agonist for the management of type 2 diabetes. · DATA SYNTHESIS

“DNP peptide, a previously identified cyclic peptide that facilitates transport across small-intestinal epithelial cells.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“This synthetic peptide mimics the action of GLP-1 at the GLP-1 receptor.”

IUPHAR ligand commentary · Mechanism of action

“To evaluate changes in recorded background glucose-lowering active-substance counts after initiation of a glucagon-like peptide-1 (GLP-1) or dual GIP/GLP-1 receptor agonist.”

Changes in recorded background glucose-lowering therapy after initiation of a GLP-1 receptor agonist or dual GIP/GLP-1 receptor agonist in adults with type 2 diabetes. · AIMS

“This synthetic peptide mimics the action of GLP-1 at the GLP-1 receptor.”

IUPHAR ligand commentary · Mechanism of action

“This research aims to overcome this limitation by developing multiple composite NNTs to derive the CPEA to estimate a total value of semaglutide and dulaglutide in people with established cardiovascular disease.”

Calculating cost per event avoided using a composite number needed to treat. · OBJECTIVE

“by increasing the amount of insulin that the pancreas releases in response to food.”

Trulicity | European Medicines Agency (EMA) · How does Trulicity work?

“Dulaglutide (100 nM) augmented the phosphorylation state of phospholamban at serine 16 and the phosphorylation state of the inhibitory subunit of troponin.”

Contractile effects of dulaglutide in the human atrium. · Abstract

“Fragment crystallizable (Fc)-fusion proteins represent a major class of biologics with extended half-lives via neonatal Fc receptor (FcRn)-mediated recycling.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“'Diabetic retinopathy' was the key search term mapped to Medical Dictionary for Regulatory Activities (MedDRA) Lower-Level Terms (LLTs).”

Association between glucagon-like peptide-1 agonists and risk of diabetic retinopathy: a disproportionality analysis using FDA adverse event reporting system data. · METHODS

“Dulaglutide-DNP retained structural integrity and FcRn-binding affinity comparable to those of unmodified dulaglutide.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“Following a single-dose administration of 0.5 mg, 0.75 mg, or 1.5 mg dulaglutide in healthy subjects, geometric mean maximum concentrations (Cmax) were 29.4, 44.2, and 81.5 ng/mL, respectively.”

Pharmacokinetics, Pharmacodynamics, and Safety of Dulaglutide After Single or Multiple Doses in Chinese Healthy Subjects and Patients with T2DM: A Randomized, Placebo-Controlled, Phase I Study. · RESULTS

“The elimination half-life of dulaglutide was approximately 5 days.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 12.3 Pharmacokinetics

“Geometric mean for half-life of 4-5 days and median time to Cmax(tmax) of approximately 48 h were observed in both study populations.”

Pharmacokinetics, Pharmacodynamics, and Safety of Dulaglutide After Single or Multiple Doses in Chinese Healthy Subjects and Patients with T2DM: A Randomized, Placebo-Controlled, Phase I Study. · RESULTS

“Following intraintestinal administration, pharmacokinetic analysis revealed that dulaglutide-DNP rapidly entered the portal vein within 10 min and could be subsequently detected in the systemic circulation.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“Dose-proportional increases in drug exposure were observed after both single and multiple dosing.”

Pharmacokinetics, Pharmacodynamics, and Safety of Dulaglutide After Single or Multiple Doses in Chinese Healthy Subjects and Patients with T2DM: A Randomized, Placebo-Controlled, Phase I Study. · RESULTS

“Tirzepatide showed slightly higher 1-year atrial fibrillation risk (HR: 1.04, [1.00-1.07]).”

Superior Cardiorenal Protection With Tirzepatide Over Dulaglutide in Heart Failure With Preserved Ejection Fraction: A Large-Scale Propensity Score-Matched Real-World Analysis. · RESULTS

“Change from baseline in weight at week 40 was -10.5 kg (SE, 0.5) with tirzepatide and -3.6 kg (SE, 0.5) with dulaglutide (estimated treatment difference, -6.9 kg [CI, -8.3 to -5.5 kg;P< 0.001]).”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · RESULTS

“In randomized controlled trials in patients with T2DM, dulaglutide monotherapy was noninferior to once-daily subcutaneous liraglutide monotherapy and significantly more effective than oral metformin monotherapy in improving glycemic control at 26 weeks.”

Dulaglutide: A Review in Type 2 Diabetes. · Abstract

“This two-part, double-blind, placebo-controlled study”

Pharmacokinetics, Pharmacodynamics, and Safety of Dulaglutide After Single or Multiple Doses in Chinese Healthy Subjects and Patients with T2DM: A Randomized, Placebo-Controlled, Phase I Study. · METHODS

“One-to-one greedy nearest-neighbor matching (caliper 0.1) on demographics, comorbidities, medications, and laboratory/echocardiographic data produced balanced cohorts of 24 305 patients each.”

Superior Cardiorenal Protection With Tirzepatide Over Dulaglutide in Heart Failure With Preserved Ejection Fraction: A Large-Scale Propensity Score-Matched Real-World Analysis. · METHODS

“This is an unblinded real-world study using propensity score analysis of consecutive patients with T2DM and MASLD received either SGLT-2i (dapagliflozin; n = 21), GLP-1RA (dulaglutide; n = 21), or dipeptidyl peptidase-4 inhibitors (DPP-4i; n = 20).”

Effects of dapagliflozin and dulaglutide on blood pressure and coronary flow in liver steatosis patients with type 2 diabetes. · METHODS

“Among veterans with T2D receiving basal insulin therapy, addition of GLP-1RA did not increase the chances of stopping insulin therapy compared with SGLT-2i or DPP-4i therapy.”

Comparative Effectiveness of Glucagon-like Peptide-1 Receptor Agonists Versus Oral Agents for Insulin Discontinuation in Type 2 Diabetes : A Target Trial Emulation. · CONCLUSION

“Compared to dulaglutide, semaglutide was also associated with reduced risk of death (HR, 0.81 [95% CI, 0.70-0.93]).”

Comparison of Specific Glucagon-Like Peptide-1 Receptor Agonists on Kidney Outcomes Among Patients With Type 2 Diabetes. · RESULTS

“In randomized controlled trials in patients with T2DM, dulaglutide monotherapy was noninferior to once-daily subcutaneous liraglutide monotherapy and significantly more effective than oral metformin monotherapy in improving glycemic control at 26 weeks.”

Dulaglutide: A Review in Type 2 Diabetes. · Abstract

“This retrospective, propensity score-matched cohort study used de-identified electronic health records from the TriNetX US Collaborative Network (as of December 2025). Adults ≥ 18 years with HFpEF (ICD-10: I50.3) initiating tirzepatide (n = 35 174) or dulaglutide (n = 52 999), without prior exposure to the comparator, were identified. One-to-one greedy nearest-neighbor matching (caliper 0.1) on demographics, comorbidities, medications, and laboratory/echocardiographic data produced balanced cohorts of 24 305 patients each. Kaplan-Meier and Cox proportional hazards models evaluated 1-year and 3-year risks of all-cause mortality, acute heart failure events, all-cause hospitalization, myocardial infarction, stroke, atrial fibrillation, MACE, MAKE, acute pancreatitis, and hypoglycemia.”

Superior Cardiorenal Protection With Tirzepatide Over Dulaglutide in Heart Failure With Preserved Ejection Fraction: A Large-Scale Propensity Score-Matched Real-World Analysis. · METHODS

“Central to this review is the analysis of the SURPASS-CVOT trial, which compared the cardiovascular protective effects of tirzepatide versus dulaglutide in individuals with type 2 diabetes and established atherosclerotic CV disease.”

GIP in Cardiovascular and Kidney Disease: From Physiology to Pharmacology. · MATERIALS AND METHODS

“Co-primary outcomes were 1-year changes in HbA1c and bodyweight, estimated using a new-user, active-comparator cohort design with marginal structural models and inverse probability of treatment weighting.”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · METHODS

“we performed both a 3-way comparison of patients initiating liraglutide, dulaglutide, or exenatide from January 1, 2015, to December 31, 2021”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · METHODS

“Dulaglutide 4.5 mg was superior to 1.5 mg for weight loss at 36 weeks for both estimands (treatment regimen: -4.6 vs. -3.0 kg, ETD -1.6 kg,P< 0.001; efficacy: -4.7 vs. -3.1 kg, ETD -1.6 kg,P< 0.001).”

Efficacy and Safety of Dulaglutide 3.0 mg and 4.5 mg Versus Dulaglutide 1.5 mg in Metformin-Treated Patients With Type 2 Diabetes in a Randomized Controlled Trial (AWARD-11). · RESULTS

“In this post hoc analysis, the dual GLP-1 and GIP agonist tirzepatide, compared with the GLP-1 agonist dulaglutide, was associated with a lower incidence of a broad 6-component composite cardiovascular and kidney end point in patients with diabetes and established cardiovascular disease.”

Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease: A Post Hoc Analysis of the SURPASS-CVOT Randomized Clinical Trial. · CONCLUSIONS

“When compared to dulaglutide and exenatide, semaglutide was associated with a reduced risk for the secondary kidney composite outcome by 8% (HR, 0.92 [95% CI, 0.87-0.97])”

Comparison of Specific Glucagon-Like Peptide-1 Receptor Agonists on Kidney Outcomes Among Patients With Type 2 Diabetes. · RESULTS

“Tirzepatide linked to lower 1-year risks of all-cause mortality (HR: 0.66, 95% CI: [0.59-0.74]), all-cause hospitalization (HR: 0.85, 95% CI: [0.82-0.88]), stroke (HR: 0.92, 95% CI: [0.87-0.97]), MACE (HR: 0.89, 95% [CI: 0.84-0.93]), MAKE (HR: 0.85, 95% CI: [0.79-0.91]), and acute pancreatitis (HR: 0.78, 95% CI: [0.63-0.96]).”

Superior Cardiorenal Protection With Tirzepatide Over Dulaglutide in Heart Failure With Preserved Ejection Fraction: A Large-Scale Propensity Score-Matched Real-World Analysis. · RESULTS

“Change from baseline in HbA1cat week 40 was -1.44% (SE, 0.07) with tirzepatide, 15 mg or MTD, and -0.67% (SE, 0.08) with dulaglutide, 4.5 mg or MTD (estimated treatment difference, -0.77% [95% CI, -0.98% to -0.56%;P< 0.001]).”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · RESULTS

“and a 2-way comparison of patients initiating semaglutide or dulaglutide between January 1, 2019, and December 31, 2021.”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · METHODS

“To compare efficacy and safety of escalation of dulaglutide dose versus switching to tirzepatide in inadequately controlled type 2 diabetes.”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · OBJECTIVE

“Dulaglutide 3.0 mg was superior to 1.5 mg for reducing HbA1c, using the efficacy estimand (ETD -0.17% [-1.9 mmol/mol];P= 0.003) but not the treatment-regimen estimand (ETD -0.10% [-1.1 mmol/mol];P= 0.096).”

Efficacy and Safety of Dulaglutide 3.0 mg and 4.5 mg Versus Dulaglutide 1.5 mg in Metformin-Treated Patients With Type 2 Diabetes in a Randomized Controlled Trial (AWARD-11). · RESULTS

“Semaglutide new users (n = 1901) achieved greater 1-year reductions than dulaglutide new users (n = 2735) in HbA1c (estimated treatment difference [ETD] -0.22 percentage points [95% CI -0.30, -0.15])”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · FINDINGS

“To evaluate and compare the risk of diabetic retinopathy and kidney disease between once-daily liraglutide and once-weekly dulaglutide in Japanese participants with type 2 diabetes (T2D).”

Comparison between liraglutide and dulaglutide on the incidence or progression of eye and kidney complications. · AIMS

“Co-primary outcomes were 1-year changes in HbA1c and bodyweight, estimated using a new-user, active-comparator cohort design with marginal structural models and inverse probability of treatment weighting.”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · METHODS

“the comparator cohort included patients without recorded GLP-1 RA exposure (n= 142,047 before matching).”

Clinical Outcomes Associated with GLP-1 Receptor Agonist Exposure in Non-Diabetic Patients with Chronic Pancreatitis: A Retrospective Cohort Study. · Abstract

“The study results showed that HEC14028 and dulaglutide were pharmacokinetically equivalent: 90% confidence interval (CI) of C max and AUC 0–∞ geometric mean ratios were 102.9%–122.0% and 97.1%–116.9%, respectively, which were both within the range of 80.00%–125.00%.”

A pharmacokinetic study comparing the biosimilar <scp>HEC14028</scp> and Dulaglutide (Trulicity®) in healthy Chinese subjects · Abstract

“Dulaglutide 1.5 mg was non-inferior to liraglutide in AWARD-6.”

Efficacy and safety of dulaglutide in the treatment of type 2 diabetes: a comprehensive review of the dulaglutide clinical data focusing on the AWARD phase 3 clinical trial program. · Abstract

“Dulaglutide 1.5 mg was associated with a reduction in 24-hour SBP and an increase in 24-hour heart rate.”

Effects of the Once-Weekly Glucagon-Like Peptide-1 Receptor Agonist Dulaglutide on Ambulatory Blood Pressure and Heart Rate in Patients With Type 2 Diabetes Mellitus · Abstract

“MACE; primary composite outcome comprising CV death, nonfatal myocardial infarction or nonfatal stroke”

Dulaglutide: A Review in Type 2 Diabetes. · Abstract

“In case 2, dulaglutide induced weight loss”

PERSPECTIVE: Beyond the GH-IGF-1 axis: a network perspective integrating clinical observations and mechanistic insights. · RESULTS

“Among GLP-1 RAs, both liraglutide (HR 0.40, 95% CI 0.20-0.80, P=0.0091) and dulaglutide (HR 0.42, 95% CI 0.19-0.92, P=0.0311) showed significant protective effects against unspecified dementia.”

Risk of Dementia after initiation of GLP-1 RA versus long-acting insulin in patients with type 2 Diabetes mellitus. · RESULTS

“TRULICITY significantly reduced the risk of first occurrence of primary composite endpoint of CV death, non-fatal MI, or non-fatal stroke (HR: 0.88, 95% CI 0.79, 0.99).”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 14.5 Cardiovascular Outcomes Trial in Adults with Type 2 Diabetes Mellitus and Cardiovascular Disease or Multiple Cardiovascular Risk Factors

“Semaglutide new users (n = 1901) achieved greater 1-year reductions than dulaglutide new users (n = 2735) in HbA1c (estimated treatment difference [ETD] -0.22 percentage points [95% CI -0.30, -0.15])”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · FINDINGS

“not meeting SUSTAIN-7 trial-eligibility (HbA1c: ETD -0.23 percentage points [95% CI -0.31, -0.15]”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · FINDINGS

“No differences were observed among different GLP-1 receptor agonists for the primary outcome”

Comparison of Specific Glucagon-Like Peptide-1 Receptor Agonists on Kidney Outcomes Among Patients With Type 2 Diabetes. · CONCLUSIONS

“the hazards for treatment of DME or PDR (HR: 0.88; 95% CI: 0.70-1.11), DME (HR: 0.89; 95% CI: 0.69-1.14)”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · RESULTS

“Change from baseline in HbA1cat week 40 was -1.44% (SE, 0.07) with tirzepatide, 15 mg or MTD, and -0.67% (SE, 0.08) with dulaglutide, 4.5 mg or MTD (estimated treatment difference, -0.77% [95% CI, -0.98% to -0.56%;P< 0.001]).”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · RESULTS

“23.4-55.7% of patients achieved HbA1c < 7.0%.”

Real-World Effectiveness of Dulaglutide in Patients with Type 2 Diabetes Mellitus: A Literature Review. · RESULTS

“In humans, GLP-1RA use was associated with BMI reduction and vitamin D augmentation without change in EDSS or relapse rate (two cohorts; n = 109).”

GLP-1 receptor agonists in multiple sclerosis: a systematic review of preclinical and clinical evidence. · RESULTS

“the CV (from 39.85 ± 4.99% to 43.26 ± 5.75%; p<0.001)”

Dulaglutide vs insulin in adolescents with thalassaemia-induced diabetes: effect on metabolism and atherogenesis (DIADEMA). · RESULTS

“Dulaglutide reduced HbA1c from baseline to 3-24 months by 0.5-2.2% across studies (n = 20)”

Real-World Effectiveness of Dulaglutide in Patients with Type 2 Diabetes Mellitus: A Literature Review. · RESULTS

“Weight was reduced by 2.1-6.4 kg across studies of 3-12 months (n = 15).”

Real-World Effectiveness of Dulaglutide in Patients with Type 2 Diabetes Mellitus: A Literature Review. · RESULTS

“Change from baseline in weight at week 40 was -10.5 kg (SE, 0.5) with tirzepatide and -3.6 kg (SE, 0.5) with dulaglutide (estimated treatment difference, -6.9 kg [CI, -8.3 to -5.5 kg;P< 0.001]).”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · RESULTS

“The key secondary end point was change from baseline in weight at week 40.”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · MEASUREMENTS

“The 12-week increases in the macupatide, dulaglutide and combination arms were, respectively: cDI, 0.2 (63.2% change), 0.5 (181.0%) and 1.0 (321.5%);”

Insulin Sensitivity and Beta Cell Function With Macupatide Alone or With Dulaglutide in Type 2 Diabetes: A Phase 1b, Randomised Controlled Trial. · RESULTS

“Dulaglutide 0.75 mg was noninferior to placebo (1.6 bpm; [0.3, 2.9]; P ≤0.02) for 24-hour heart rate (least squares mean difference [95% confidence interval]), but dulaglutide 1.5 mg was not (2.8 bpm [1.5, 4.2]).”

Effects of the Once-Weekly Glucagon-Like Peptide-1 Receptor Agonist Dulaglutide on Ambulatory Blood Pressure and Heart Rate in Patients With Type 2 Diabetes Mellitus · Abstract

“bodyweight: ETD -2.01 kg [95% CI -3.07, -0.95]”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · FINDINGS

“and did not increase the beating rate of spontaneously beating mouse right atrial preparations.”

Contractile effects of dulaglutide in the human atrium. · Abstract

“At 26 weeks, the mean glycated hemoglobin level had increased in the placebo group (0.6 percentage points) and had decreased in the dulaglutide groups (-0.6 percentage points in the 0.75-mg group and -0.9 percentage points in the 1.5-mg group, P < 0.001 for both comparisons vs. placebo).”

Once-Weekly Dulaglutide for the Treatment of Youths with Type 2 Diabetes. · Abstract

“and bodyweight (ETD -1.92 kg [95% CI -2.91, -0.93])”

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study. · FINDINGS

“GLP-1RAs consistently reduced clinical severity in EAE models through multiple mechanisms (AMPK/SIRT1 activation, NLRP3 suppression, Th1/Th17 modulation, microglial deactivation).”

GLP-1 receptor agonists in multiple sclerosis: a systematic review of preclinical and clinical evidence. · RESULTS

“and PDR (HR: 0.70; 95% CI: 0.45-1.09) all found no difference between drugs.”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · RESULTS

“Based on outcomes from ten studies, 27.2-61.0% of dulaglutide patients were adherent.”

Real-World Effectiveness of Dulaglutide in Patients with Type 2 Diabetes Mellitus: A Literature Review. · RESULTS

“Primary outcome was mean reduction in body weight from baseline following treatment with GLP1RA-BT.”

Safety and Efficacy of Glucagon Like Peptide-1 Receptor Agonism-Based Therapies in End-Stage Renal Disease: A Systematic Review and Meta-Analysis. · METHODS

“A total of 29 studies (11 articles; 18 abstracts) were included.”

Real-World Effectiveness of Dulaglutide in Patients with Type 2 Diabetes Mellitus: A Literature Review. · RESULTS

“In conclusion, dulaglutide is an effective treatment for T2DM and has an acceptable tolerability and safety profile.”

Efficacy and safety of dulaglutide in the treatment of type 2 diabetes: a comprehensive review of the dulaglutide clinical data focusing on the AWARD phase 3 clinical trial program. · Abstract

“In mice, intravenous dulaglutide-DNP lowered blood glucose levels as effectively as unmodified dulaglutide, suggesting that DNP peptide fusion did not impair the intrinsic pharmacological activity of dulaglutide.”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“A lower count occurred in 17.2% of patients, no change in 38.8%, and a higher count in 44.0%, most frequently with dulaglutide (52.9%) and least with tirzepatide (20.4%).”

Changes in recorded background glucose-lowering therapy after initiation of a GLP-1 receptor agonist or dual GIP/GLP-1 receptor agonist in adults with type 2 diabetes. · RESULTS

“We detected a concentration- and time-dependent positive inotropic effect of dulaglutide in HAP.”

Contractile effects of dulaglutide in the human atrium. · Abstract

“we identified no difference in the risk of sight-threatening diabetic retinopathy after initiation of different GLP-1 RA agents among adults with type 2 diabetes at moderate cardiovascular risk.”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · CONCLUSIONS

“When comparing patients who initiated treatment with exenatide (n = 14 076, median follow-up 969 days; interquartile range [IQR] 578-1444) to those starting dulaglutide (n = 54 787, median follow-up 948 days; IQR 551-1457) or liraglutide (n = 25 562, median follow-up 1007 days; IQR 575-1494), no differences were found in the hazard (hazard ratio [HR]) of composite treatment for DME or PDR: exenatide versus dulaglutide (HR 0.90; 95% confidence interval (CI): 0.73-1.12)”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · RESULTS

“The primary end point was change from baseline to week 16 in mean 24-hour SBP, a tree gatekeeping strategy compared the effects of dulaglutide to placebo.”

Effects of the Once-Weekly Glucagon-Like Peptide-1 Receptor Agonist Dulaglutide on Ambulatory Blood Pressure and Heart Rate in Patients With Type 2 Diabetes Mellitus · Abstract

“A primary kidney composite outcome inclusive of incident diagnosis codes for CKD stages 3-4 and kidney failure (inclusive of CKD stage 5 and kidney replacement therapy).”

Comparison of Specific Glucagon-Like Peptide-1 Receptor Agonists on Kidney Outcomes Among Patients With Type 2 Diabetes. · OUTCOME

“and reduced insulin requirements in a patient with PWS”

PERSPECTIVE: Beyond the GH-IGF-1 axis: a network perspective integrating clinical observations and mechanistic insights. · RESULTS

“Mean persistence was 146-152 days and > 250 days in 6- and 12-month studies, respectively.”

Real-World Effectiveness of Dulaglutide in Patients with Type 2 Diabetes Mellitus: A Literature Review. · RESULTS

“A secondary kidney composite outcome included the elements of the primary composite outcome plus death from any cause.”

Comparison of Specific Glucagon-Like Peptide-1 Receptor Agonists on Kidney Outcomes Among Patients With Type 2 Diabetes. · OUTCOME

“After 26 weeks of treatment, patients on Trulicity had a reduction in HbA1c levels of 0.7 percentage points, versus an increase of 0.6 percentage points for patients on placebo.”

Trulicity | European Medicines Agency (EMA) · What benefits of Trulicity have been shown in studies?

“After a median (IQR) treatment duration of 46.9 (34.6-50.6) months, the primary cardiorenal end point occurred in 1559 tirzepatide-treated patients (23.7%) and 1803 dulaglutide-treated patients (27.4%; hazard ratio [HR], 0.84; 95% CI, 0.79-0.90; P < .001).”

Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease: A Post Hoc Analysis of the SURPASS-CVOT Randomized Clinical Trial. · RESULTS

“At the primary endpoint, in five of the six studies, once weekly dulaglutide 1.5 mg was superior to the active comparator [exenatide, insulin glargine (two studies), metformin, and sitagliptin], with a greater proportion of patients reaching glycated hemoglobin A1c (HbA1c) targets of <7.0% (53.0 mmol/mol) and ≤6.5% (47.5 mmol/mol).”

Efficacy and safety of dulaglutide in the treatment of type 2 diabetes: a comprehensive review of the dulaglutide clinical data focusing on the AWARD phase 3 clinical trial program. · Abstract

“Dulaglutide 0.75 mg was noninferior to placebo (1.6 bpm; [0.3, 2.9]; P ≤0.02) for 24-hour heart rate (least squares mean difference [95% confidence interval]), but dulaglutide 1.5 mg was not (2.8 bpm [1.5, 4.2]).”

Effects of the Once-Weekly Glucagon-Like Peptide-1 Receptor Agonist Dulaglutide on Ambulatory Blood Pressure and Heart Rate in Patients With Type 2 Diabetes Mellitus · Abstract

“pharmacodynamic analysis demonstrated that intraintestinal dulaglutide-DNP administration significantly reduced blood glucose levels to 39.0 % of the baseline,”

Small intestine-permeable cyclic peptide-mediated enhancement of Fc-fusion protein absorption in mice. · Abstract

“Likewise, when comparing patients initiating semaglutide (n = 30 911, median follow-up 625 days [IQR: 455-850]) versus dulaglutide (n = 32 844, median follow-up 639 days [IQR: 459-878]), the hazards for treatment of DME or PDR (HR: 0.88; 95% CI: 0.70-1.11)”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · RESULTS

“When comparing patients who initiated treatment with exenatide (n = 14 076, median follow-up 969 days; interquartile range [IQR] 578-1444) to those starting dulaglutide (n = 54 787, median follow-up 948 days; IQR 551-1457) or liraglutide (n = 25 562, median follow-up 1007 days; IQR 575-1494), no differences were found in the hazard (hazard ratio [HR]) of composite treatment for DME or PDR: exenatide versus dulaglutide (HR 0.90; 95% confidence interval (CI): 0.73-1.12), liraglutide versus dulaglutide (HR: 0.97; 95% CI: 0.79-1.19)”

Risk of Sight-Threatening Diabetic Retinopathy with Glucagon-Like Peptide-1 Receptor Agonist Use in Routine Clinical Practice: Comparative Effectiveness of Semaglutide, Dulaglutide, Liraglutide, and Exenatide. · RESULTS

“The primary end point was change from baseline in HbA1cat week 40.”

Comparison of Dose Escalation Versus Switching to Tirzepatide Among People With Type 2 Diabetes Inadequately Controlled on Lower Doses of Dulaglutide : A Randomized Clinical Trial. · MEASUREMENTS

“Trulicity is a medicine used in adults and children from 10 years of age with type 2 diabetes.”

Trulicity | European Medicines Agency (EMA) · Overview

“TRULICITY is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · WARNING: RISK OF THYROID C-CELL TUMORS

“TRULICITY is contraindicated in patients with:Personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 4 CONTRAINDICATIONS

“as monotherapy when metformin is considered inappropriate due to intolerance or contraindications”

Trulicity | European Medicines Agency (EMA) · Therapeutic indication

“TRULICITY delays gastric emptying and thus has the potential to reduce the rate of absorption of concomitantly administered oral medications.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 7.1 Oral Medications

“In male and female rats, dulaglutide causes a dose-related and treatment-duration-dependent increase in the incidence of thyroid C-cell tumors (adenomas and carcinomas) after lifetime exposure.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · WARNING: RISK OF THYROID C-CELL TUMORS

“In male and female rats, dulaglutide causes a dose-related and treatment-duration-dependent increase in the incidence of thyroid C-cell tumors (adenomas and carcinomas) after lifetime exposure.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · WARNING: RISK OF THYROID C-CELL TUMORS

“The most common side effects with Trulicity (which may affect more than 1 in 10 people) are nausea (feeling sick), vomiting and diarrhoea.”

Trulicity | European Medicines Agency (EMA) · What are the risks associated with Trulicity?

“As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 1 INDICATIONS AND USAGE

“TRULICITY®is indicated:As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 1 INDICATIONS AND USAGE

“To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 1 INDICATIONS AND USAGE

“To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 1 INDICATIONS AND USAGE

“It is available as prefilled pens containing a solution to be injected under the skin in the abdomen (belly), in the thigh or in the upper arm.”

Trulicity | European Medicines Agency (EMA) · How is Trulicity used?

“The maximum recommended dosage is 4.5 mg injected subcutaneously once weekly.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 2.1 Adult Dosage

“The recommended starting dosage of TRULICITY is 0.75 mg injected subcutaneously once weekly.”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 2.1 Adult Dosage

“Injection: TRULICITY is a clear and colorless solution available as:0.75 mg/0.5 mL solution in a single-dose pen1.5 mg/0.5 mL solution in a single-dose pen3 mg/0.5 mL solution in a single-dose pen4.5 mg/0.5 mL solution in a single-dose pen”

These highlights do not include all the information needed to use TRULICITY safely and effectively. See full prescribing information for TRULICITY.TRULICITY (dulaglutide) injection, for subcutaneous useInitial U.S. Approval: 2014 · 3 DOSAGE FORMS AND STRENGTHS