{
  "release_id": "5dcd9b263fe17744",
  "id": "cardio:tirzepatide",
  "owner": "cardio",
  "kind": "drug",
  "slug": "tirzepatide",
  "name": "Tirzepatide",
  "aliases": [
    "Tirzepatide"
  ],
  "atlases": [
    "cardio"
  ],
  "summary_plain": "The medicine inside Mounjaro. It is given as an injection once a week and acts on two receptors, called GIP and GLP-1. The SURPASS-CVOT trial compared it with dulaglutide in adults with type 2 diabetes and heart or blood-vessel disease.",
  "summary_technical": "RxNorm ingredient 2601723. By established pharmacologic class (RxClass) it is both a GLP-1 receptor agonist and a glucose-dependent insulinotropic polypeptide receptor agonist, so it is filed as a member of the GLP-1 class. SURPASS-CVOT found it noninferior to dulaglutide for a composite of cardiovascular death, myocardial infarction or stroke (hazard ratio 0.92, 95.3% CI 0.83 to 1.01).",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": null,
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  "navigation": {
    "cardio": {
      "system": [
        "metabolism"
      ],
      "condition-area": [
        "diabetes-and-metabolic-disease"
      ]
    }
  },
  "payload": {
    "level": "substance",
    "mechanism": "A dual incretin agonist of the glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptors."
  },
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      "statement": "SURPASS-CVOT compared a weekly injection of tirzepatide (up to 15 mg) with weekly dulaglutide (1.5 mg), an agent shown to reduce cardiovascular events, in people who have type 2 diabetes together with atherosclerotic cardiovascular disease. The analysis population was 6586 patients on tirzepatide and 6579 on dulaglutide. The first death from cardiovascular causes, heart attack or stroke occurred in 801 patients (12.2%) on tirzepatide and 862 (13.1%) on dulaglutide (hazard ratio 0.92; 95.3% CI 0.83 to 1.01; P=0.003 for noninferiority; P=0.09 for superiority). Tirzepatide was therefore noninferior to dulaglutide, but the trial did not show that it was superior. Adverse events appeared similar in the two groups, with more gastrointestinal adverse events on tirzepatide.",
      "context": {
        "id": "cardio:ctx-surpass-cvot-adults-type-2-diabetes-ascvd",
        "label": "Adults with type 2 diabetes and atherosclerotic cardiovascular disease (SURPASS-CVOT)",
        "recipient": "adult",
        "population": "Patients with type 2 diabetes and atherosclerotic cardiovascular disease. The registry gives a minimum age of 40 years. The modified intention-to-treat population had a mean age of 64.1 years and 29.0 percent were women.",
        "care_setting": "Multicenter trial. The care setting is not described further in the sources read.",
        "geography": "Multinational. The registry lists the sites by country on the study page.",
        "life_stage_note": "Patients aged 40 years or older (registry minimum age 40 years); mean age 64.1 years",
        "life_stage_terms": null,
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "gestational_age_basis": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Follow-up time is not given in the abstract.",
        "eligibility": {
          "inclusion": [
            "Type 2 diabetes",
            "Atherosclerotic cardiovascular disease"
          ],
          "exclusion": []
        }
      },
      "evidence_stage": "interventional",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "The comparison is with another GLP-1 medicine, not with placebo, so the result does not show how tirzepatide compares with no treatment. Noninferiority was tested with a margin of 1.05 for the upper limit of the 95.3% confidence interval; the abstract sets an upper limit below 1.00 as superiority, which was not reached. Funded by Eli Lilly (named in the abstract). Only the PubMed abstract was read.",
      "editorial_state": "draft",
      "checked_at": "2026-10-14",
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            "publication_date": "2025-12-18",
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