GLP-1 Medications: Ozempic vs. Trulicib (semaglutide vs. dulaglutide)
From my experience, Ozempic and Trulicity are the most commonly used GLP1's. Both are weekly dosed injections. So how do we choose what to initiate for our patients?? (besides insurance deciding for us...). The SUSTAIN7 trial was a head-to-head trial of Ozempic (semaglutide) vs. Trulicity (dulaglutide). The results demonstrated that Ozempic had statistically significantly better A1c lowering and weight loss. However, clinical significance of these differences is debatable (roughly additional -0.3% A1c, 5 lbs weight loss). These results favor Ozempic, but Trulicity has some benefits as well. Unlike Ozempic which requires a 4 week onboarding dose (0.25 mg x 4 weeks before increasing to the maintenance of 0.5 mg weekly, then increase to 1 mg weekly if needed), Trulicity does not require dose titration. Instead Trulicity is just started at 0.75 mg weekly, and can be increased to 1.5 mg weekly if needed. Additionally, while Ozempic is pretty easy to use, many people find Trulicity even easier to use since it's an auto-injector and patients do not need to visually see the needle with this device. Hopefully this overview is helpful to you in making patient-specific choices. Which GLP1 do you see used most often??
Both of these GLP1's have had trials demonstrating positive CV benefits (SUSTAIN6 and REWIND trials). As a reminder, we use GLP1's only for type 2 diabetes, as one of our many 2nd line options after metformin. We consider these drugs particularly for patients who have ASCVD or HF, if patients need weight loss, or if we need to minimize hypoglycemia risk.
#Ozempic #Trulicib #semaglutide #dulaglutide #Pharmacology #Diabetes #Comparison