From the Research
Trulicity (dulaglutide) may help lower LDL cholesterol, but this is not its primary purpose, and its effectiveness in doing so is modest, typically around 3-5% reduction in LDL cholesterol levels. Trulicity is a GLP-1 receptor agonist primarily prescribed for type 2 diabetes management and cardiovascular risk reduction.
Key Points to Consider
- Clinical studies have shown that Trulicity works primarily by improving insulin secretion, slowing gastric emptying, and reducing glucagon production 1.
- The cholesterol-lowering effect of Trulicity likely occurs through multiple mechanisms, including improved glucose metabolism, weight loss, and possibly direct effects on lipid metabolism.
- If the main goal is to lower LDL cholesterol, dedicated cholesterol-lowering medications like statins would be more effective, as supported by a study comparing ezetimibe and PCSK9 inhibitors in patients not receiving statins, which found that PCSK9 inhibitors lowered LDL-C levels significantly more than ezetimibe 2.
- However, if a patient has type 2 diabetes and elevated cholesterol, Trulicity might provide a modest additional benefit alongside its primary glucose-lowering effects.
Dosage and Administration
- The typical starting dose of Trulicity is 0.75 mg injected subcutaneously once weekly, often increased to 1.5 mg weekly for better glycemic control 1.
Considerations for Use
- It's essential to weigh the benefits of using Trulicity for its secondary effect on LDL cholesterol against the use of dedicated cholesterol-lowering medications, considering the patient's overall health profile and treatment goals.
- The most recent and highest quality study on the topic, a 2021 meta-analysis, suggests that for patients not receiving statins, PCSK9 inhibitors are more effective than ezetimibe in lowering LDL-C levels 2, which implies that Trulicity's modest effect on LDL cholesterol may not be the most effective strategy for managing high cholesterol.