From the Guidelines
Trulicity (dulaglutide) is preferred over Victoza (liraglutide) for patients with type 2 diabetes due to its once-weekly injection frequency and similar efficacy in reducing cardiovascular risk and promoting weight loss, as demonstrated in the REWIND trial 1. When considering the treatment of type 2 diabetes, both Trulicity and Victoza are effective options, but they have distinct differences in their administration and potential benefits.
- Trulicity is administered via once-weekly injections, with typical doses ranging from 0.75mg to 4.5mg weekly, making it a more convenient option for patients who struggle with daily medication adherence.
- Victoza, on the other hand, requires daily injections, starting at 0.6mg daily for one week, then increasing to 1.2mg or 1.8mg daily, offering more flexibility in dosing adjustments. Both medications have been shown to effectively lower blood sugar, promote weight loss, and reduce cardiovascular risk, with similar side effect profiles that include nausea, vomiting, and diarrhea, which typically improve over time 1. The choice between Trulicity and Victoza should be based on individual patient factors, including insurance coverage, patient preference for injection frequency, and specific health considerations, such as the presence of cardiovascular disease or chronic kidney disease. It is essential to note that both medications should be injected subcutaneously in the abdomen, thigh, or upper arm, and patients should rotate injection sites to prevent tissue changes. In terms of cardiovascular benefits, the REWIND trial demonstrated that dulaglutide reduced the risk of major adverse cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes, in patients with type 2 diabetes 1. Similarly, the LEADER trial showed that liraglutide reduced the risk of major adverse cardiovascular events, including myocardial infarction, stroke, or cardiovascular death, in patients with type 2 diabetes at high risk for cardiovascular disease 1. However, the most recent and highest-quality study, the REWIND trial, supports the use of Trulicity (dulaglutide) as a preferred option for patients with type 2 diabetes due to its convenience and efficacy in reducing cardiovascular risk 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Comparison of Trulicity and Victoza
- Trulicity (dulaglutide) is a once-weekly subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist, as described in the study 2.
- Victoza (liraglutide) is also a GLP-1 receptor agonist, but it is administered once-daily, as mentioned in the study 2.
- In terms of efficacy, dulaglutide was noninferior to liraglutide in improving glycemic control at 26 weeks, as reported in the study 2.
- Dulaglutide was also associated with consistent reductions in body weight, as noted in the study 2.
Safety and Tolerability
- The most frequently reported adverse events in clinical trials of dulaglutide were gastrointestinal-related, such as nausea, vomiting, and diarrhea, as stated in the study 2.
- There are concerns about the risks of pancreatitis and pancreatic and thyroid cancers associated with GLP-1-based therapies, including dulaglutide and liraglutide, as discussed in the study 3.
- However, dulaglutide was generally well tolerated, with a low inherent risk of hypoglycemia, as reported in the study 2.
Clinical Evidence
- Several large clinical studies have shown that GLP-1 receptor agonists, including dulaglutide, are safe and efficacious in people living with type 2 diabetes and compromised renal function, as noted in the study 4.
- Dulaglutide has been shown to be effective in improving glycemic control and reducing body weight in patients with type 2 diabetes, as reported in the study 5.
- The study 6 also mentions dulaglutide as the third once-weekly GLP-1 agonist for type-2 diabetes.