From the Guidelines
Mounjaro (Tirzepatide) has a greater Hemoglobin A1c (HbA1c) benefit compared to Trulicity (Dulaglutide).
Comparative HbA1c Benefit
- The evidence suggests that tirzepatide has a greater reduction in HbA1c levels compared to dulaglutide, with some studies indicating that tirzepatide is one of the most effective medications for reducing HbA1c levels 1.
- A systematic review and network meta-analysis found that tirzepatide and semaglutide, a GLP-1 RA, had the greatest reductions in HbA1c levels, with tirzepatide being a dual GIP and GLP-1 RA 1.
- The American Diabetes Association recommends considering medications like tirzepatide and semaglutide for their high efficacy in reducing HbA1c levels and their additional benefits, such as weight loss and lower risk of hypoglycemia 1.
Clinical Considerations
- When choosing between tirzepatide and dulaglutide, clinicians should consider individual patient factors, such as glycemic goals, weight management goals, and risk of hypoglycemia 1.
- Tirzepatide may be a better option for patients who require a more potent glucose-lowering agent and have a high risk of hypoglycemia or need to manage their weight 1.
- However, the evidence is based on a systematic review and network meta-analysis, which may have limitations, such as sparse data and possible incoherence due to differences in baseline patient characteristics and usual care 1.
From the FDA Drug Label
In adult patients with type 2 diabetes mellitus, treatment with MOUNJARO produced a statistically significant reduction from baseline in HbA1c compared to placebo Add-on to metformin SURPASS-2 (NCT03987919) was a 40-week open-label trial (double-blind with respect to MOUNJARO dose assignment) that randomized 1879 adult patients with type 2 diabetes mellitus with inadequate glycemic control on stable doses of metformin alone to the addition of MOUNJARO 5 mg, MOUNJARO 10 mg, or MOUNJARO 15 mg once weekly or subcutaneous semaglutide 1 mg once weekly.
The comparative Hemoglobin A1c (HbA1c) benefit of Mounjaro (Tirzepatide) versus Trulicity (Dulaglutide) is not directly stated in the provided drug label, as Trulicity (Dulaglutide) is not mentioned. However, the label does compare Mounjaro to semaglutide, which is a different medication. Key points:
- Mounjaro was compared to placebo and semaglutide in clinical trials.
- The label does not provide a direct comparison between Mounjaro and Trulicity. 2
From the Research
Comparative Hemoglobin A1c (HbA1c) Benefit
- The comparative HbA1c benefit of Mounjaro (Tirzepatide) versus Trulicity (Dulaglutide) is not directly stated in the provided studies, but some studies provide information on the efficacy of tirzepatide compared to other treatments.
- A study published in 2023 3 found that tirzepatide had a greater HbA1c reduction compared to semaglutide, with a relative reduction ranging from 0.44% to 2.11%.
- Another study published in 2024 4 is currently investigating the comparison of tirzepatide and dulaglutide on major adverse cardiovascular events in participants with type 2 diabetes and atherosclerotic cardiovascular disease, but the results are not yet available.
- A cost-effectiveness analysis published in 2023 5 compared tirzepatide to semaglutide and found that tirzepatide was associated with a higher cost and larger reduction in HbA1c and body weight.
Efficacy of Tirzepatide
- Studies have shown that tirzepatide is effective in reducing HbA1c levels in adults with type 2 diabetes, with absolute reductions up to 3.02% 3.
- Tirzepatide has also been shown to be effective in reducing HbA1c levels in adults with type 1 diabetes, with a significant reduction of 0.45% at 3 months and 0.59% at 8 months 6.
- A retrospective chart review published in 2025 7 found that tirzepatide was associated with a decline in HbA1c of 0.68% over 12 months in adults with type 1 diabetes.
Comparison to Dulaglutide
- The SURPASS-CVOT trial 4 is currently comparing the efficacy of tirzepatide to dulaglutide in terms of major adverse cardiovascular events, but the results are not yet available.
- There is no direct comparison of the HbA1c benefit of tirzepatide versus dulaglutide in the provided studies.