What is the comparative efficacy of dulaglutide (Trulicity) versus semaglutide (Ozempic) for weight loss?

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Last updated: February 17, 2025View editorial policy

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From the Guidelines

Comparative Efficacy of Dulaglutide and Semaglutide for Weight Loss

Dulaglutide (Trulicity) and semaglutide (Ozempic) are both glucagon-like peptide-1 receptor agonists, but semaglutide has been shown to result in greater weight loss compared to dulaglutide, with mean weight losses of 10-15% of initial body weight over 26-68 weeks 1.

  • The higher dose and potency of semaglutide may contribute to its superior efficacy in promoting weight loss.
  • Both medications demonstrate significant weight reduction benefits when used in conjunction with lifestyle modifications.
  • In clinical trials, such as the STEP trial, weekly semaglutide (2.4 mg) reduced the mean body weight from baseline by 14.9% in patients who were non-diabetic, overweight or obese 1.
  • The weight loss effects of semaglutide are thought to be mediated by its effects on appetite, satiety, and calorie intake, as well as its cardioprotective effects 1.
  • It is essential to note that long-term use of semaglutide is necessary to maintain weight loss, as significant weight regain can occur after cessation of treatment 1.
  • While dulaglutide also promotes weight loss, the available evidence suggests that semaglutide is more effective for this purpose, especially in patients without diabetes 1.

From the Research

Comparative Efficacy of Dulaglutide and Semaglutide for Weight Loss

  • The comparative efficacy of dulaglutide (Trulicity) versus semaglutide (Ozempic) for weight loss has been studied in several clinical trials 2.
  • A systematic review and meta-analysis found that semaglutide had a greater mean weight loss compared to dulaglutide (-2.85,95% CI = -5.59,0.11) 2.
  • Another study found that semaglutide demonstrated increased numerical weight loss compared to dulaglutide, with semaglutide resulting in a mean weight loss of 4.81 kg and dulaglutide resulting in a mean weight loss of 4.03 kg 2.
  • However, it is worth noting that tirzepatide, a dual-agonist, produced greater weight loss compared to semaglutide (-3.78,95% CI = -5.52, -2.04) 2.

Efficacy of Semaglutide for Weight Loss

  • Semaglutide has been shown to be effective for weight loss in several clinical trials, with a mean weight loss of 4.81 kg 2.
  • A double-blind trial found that semaglutide resulted in a mean change in body weight from baseline to week 68 of -14.9% compared to -2.4% with placebo, for an estimated treatment difference of -12.4 percentage points (95% CI, -13.4 to -11.5; P<0.001) 3.
  • Another study found that semaglutide resulted in a greater percentage of participants achieving weight reductions of 5% or more (86.4% vs. 31.5%), 10% or more (69.1% vs. 12.0%), and 15% or more (50.5% vs. 4.9%) at week 68 (P<0.001 for all three comparisons of odds) 3.

Comparison of Dulaglutide and Semaglutide

  • Semaglutide has been found to outperform dulaglutide in both HbA1c reduction and weight loss 4.
  • However, the use of semaglutide for weight loss is often limited by insurance coverage, with many insurance companies requiring a prior authorization proving FDA-approved diagnosis of T2DM 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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