What is the effect of Trulicity (Dulaglutide)?

From the Guidelines

Trulicity (dulaglutide) has been shown to reduce the risk of major adverse cardiovascular events (MACE), heart failure, and cardiovascular death in patients with type 2 diabetes, particularly those with established atherosclerotic cardiovascular disease or high-risk indicators 1.

Key Benefits of Trulicity

• Reduces MACE, heart failure, and cardiovascular death in high-risk patients with type 2 diabetes
• Can be considered in patients without established cardiovascular disease but with indicators of high risk, such as coronary, carotid, or lower extremity artery stenosis, left ventricular hypertrophy, or albuminuria
• May contribute to weight loss and improve glycemic control

Important Considerations

• Should be used in conjunction with lifestyle modifications and other glucose-lowering therapies as needed
• Common side effects include nausea, vomiting, and diarrhea, which often improve over time
• Patients should be educated on proper injection technique, storage, and administration of the medication

Clinical Use

• Typically started at a dose of 0.75mg weekly, with potential increases to 1.5mg after 4 weeks if needed for better blood sugar control
• Higher doses (3mg and 4.5mg) may be prescribed for additional glycemic control
• Should be injected subcutaneously in the abdomen, thigh, or upper arm, and can be administered at any time of day, with or without food

Patient Selection

• Patients with type 2 diabetes and established atherosclerotic cardiovascular disease or high-risk indicators should be considered for treatment with Trulicity
• Providers should engage in shared decision making with patients to determine the best course of treatment, taking into account individual risk factors and medical history 1

From the FDA Drug Label

TRULICITY contains dulaglutide, which is a human GLP-1 receptor agonist with 90% amino acid sequence homology to endogenous human GLP-1 (7-37). 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.

The effect of Trulicity (Dulaglutide) is to:

• Lower fasting glucose and reduce postprandial glucose (PPG) concentrations in patients with type 2 diabetes mellitus
• Increase glucose-dependent insulin release by activating the GLP-1 receptor and increasing intracellular cyclic AMP (cAMP) in beta cells
• Decrease glucagon secretion
• Slow gastric emptying 2

From the Research

Effects of Trulicity (Dulaglutide)

• Trulicity (Dulaglutide) is a once-weekly subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist that has been shown to be effective in improving glycemic control in patients with type 2 diabetes 3, 4, 5, 6.
• Dulaglutide has been found to be noninferior to once-daily subcutaneous liraglutide and significantly more effective than oral metformin, sitagliptin, exenatide, and insulin glargine in terms of improvements in glycated hemoglobin from baseline 3, 4.
• The medication has also been associated with consistent reductions in body weight, particularly at a dose of 1.5 mg once weekly 3.
• Dulaglutide has been found to have a low inherent risk of hypoglycemia and is generally well tolerated, with the most frequently reported adverse events being gastrointestinal-related (e.g., nausea, vomiting, and diarrhea) 3, 6.

Cardiovascular Benefits

• Dulaglutide has been shown to have cardiovascular benefits, including a significant reduction in the risk of major adverse cardiac events (MACE) in patients with type 2 diabetes 5.
• The medication has also been found to improve beta-cell function, lower blood pressure, and improve lipid levels 6.

Comparison to Other GLP-1 Receptor Agonists

• Dulaglutide has been found to have similar efficacy and safety to other GLP-1 receptor agonists, including liraglutide, exenatide, and semaglutide 4, 6, 7.
• The medication is recommended as a preferred first injectable glucose-lowering therapy for type 2 diabetes, due to its effectiveness in reducing HbA1c and body weight, as well as its low risk of hypoglycemic episodes 7.