{"id":"dulaglutide","name":"Dulaglutide","aliases":["Trulicity","LY2189265","GLP-1 receptor agonist"],"url":"https://lyoresearch.com/compounds/dulaglutide","class":{"id":"glp-1-agonists","name":"GLP-1 and incretin agonists","url":"https://lyoresearch.com/classes/glp-1-agonists"},"summary":"Dulaglutide is a once-weekly GLP-1 receptor agonist made of two GLP-1 analogue chains fused to an antibody fragment, approved for type 2 diabetes since 2014. In the 9,901-person REWIND trial it reduced major cardiovascular events by 12% relative to placebo over 5.4 years in people with diabetes, most of whom had no prior heart disease. It is not approved for weight management and produces modest weight loss — a few kilograms — well below semaglutide or tirzepatide. It is prescription-only everywhere it is sold.","overall_grade":"A","overall_grade_meaning":"established in humans","human_trials":"REWIND (n=9,901) + AWARD programme","regulatory_status":"Approved (Rx)","molecule":{"formula":null,"molecular_weight":null,"cas":null,"pubchem_cid":null,"note":"A fusion protein (two GLP-1 analogue chains on an antibody Fc fragment) — no small-molecule record"},"pharmacokinetics":{"basis":"label","route":"Subcutaneous injection, once weekly","half_life":"About 5 days","licensed_regimen":"0.75 mg weekly; after 4 weeks increase to 1.5 mg weekly; may increase in 1.5 mg increments after at least 4 weeks; maximum 4.5 mg weekly","product":"Trulicity","source":{"title":"Trulicity prescribing information (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=463050bd-2b1c-40f5-b3c3-0a04bb433309"}},"outcomes":[{"outcome":"Major cardiovascular events (type 2 diabetes)","grade":"A","grade_meaning":"established in humans","effect_size":"small","adverse":false,"human_studies":"1 large RCT (n=9,901, median 5.4 yr)","evidence":"Twelve percent fewer heart attacks, strokes and cardiovascular deaths than placebo, in a population where two-thirds had risk factors but no prior cardiovascular disease — the broadest such population of any GLP-1 outcomes trial.","references":[{"citation":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","where":"Lancet, 2019","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/"}],"verbatim":{"text":"During a median follow-up of 5·4 years (IQR 5·1-5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants at an incidence rate of 2·7 per 100 person-years in the placebo group (hazard ratio [HR] 0·88, 95% CI 0·79-0·99; p=0·026).","citation":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/"}},{"outcome":"Blood glucose (HbA1c)","grade":"A","grade_meaning":"established in humans","effect_size":"moderate","adverse":false,"human_studies":"AWARD programme (10+ RCTs)","evidence":"Approval-grade reductions in HbA1c across the AWARD trials against placebo and active comparators; the licensed indication.","references":[{"citation":"Dulaglutide (Trulicity) product information and the AWARD clinical programme.","where":"FDA / EMA product information","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/trulicity"}]},{"outcome":"Body weight","grade":"A","grade_meaning":"established in humans","effect_size":"small","adverse":false,"human_studies":"AWARD programme","evidence":"Consistent but modest weight loss of a few kilograms at the diabetes doses; higher doses (3 mg, 4.5 mg) add a little more. It is not approved for weight management and is not comparable to semaglutide 2.4 mg or tirzepatide.","references":[{"citation":"Dulaglutide (Trulicity) product information and the AWARD clinical programme.","where":"FDA / EMA product information","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/trulicity"}]},{"outcome":"All-cause mortality","grade":"A","grade_meaning":"established in humans","effect_size":"not measurable","adverse":false,"human_studies":"REWIND","evidence":"Deaths from any cause were numerically lower but the difference was not statistically significant.","references":[{"citation":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","where":"Lancet, 2019","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/"}],"verbatim":{"text":"All-cause mortality did not differ between groups (536 [10·8%] in the dulaglutide group vs 592 [12·0%] in the placebo group; HR 0·90, 95% CI 0·80-1·01; p=0·067).","citation":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/"}},{"outcome":"Gastrointestinal adverse effects","grade":"A","grade_meaning":"established in humans","effect_size":"moderate","adverse":true,"human_studies":"REWIND","evidence":"Nearly half of participants reported a gastrointestinal adverse event over the trial, against a third on placebo — the class profile.","references":[{"citation":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","where":"Lancet, 2019","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/"}],"verbatim":{"text":"2347 (47·4%) participants assigned to dulaglutide reported a gastrointestinal adverse event during follow-up compared with 1687 (34·1%) participants assigned to placebo (p<0·0001).","citation":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/"}}],"regions":[{"region":"European Union","status":"Approved, prescription-only","note":"Centrally authorised (Trulicity) for type 2 diabetes since 2014."},{"region":"United States","status":"Approved, prescription-only","note":"FDA-approved 2014 for type 2 diabetes; 2020 for cardiovascular risk reduction in type 2 diabetes."},{"region":"United Kingdom","status":"Licensed, prescription-only","note":"MHRA-licensed for type 2 diabetes."},{"region":"Australia","status":"Registered, prescription-only","note":"On the ARTG for type 2 diabetes."},{"region":"Canada","status":"Authorised, prescription-only","note":"Health Canada-authorised for type 2 diabetes."},{"region":"Sport (WADA)","status":"Not prohibited","note":"GLP-1 receptor agonists are not on the Prohibited List."}],"faq":[{"q":"Is dulaglutide good for weight loss?","a":"It causes modest weight loss — a few kilograms at diabetes doses — and is not approved for weight management. Semaglutide 2.4 mg and tirzepatide produce several times more."},{"q":"Does dulaglutide protect the heart?","a":"In REWIND, yes: 12% fewer major cardiovascular events over 5.4 years in people with type 2 diabetes, including those with risk factors but no prior heart disease. Deaths overall were not significantly reduced."},{"q":"Dulaglutide or semaglutide?","a":"Both are weekly GLP-1 drugs with cardiovascular-outcome evidence in diabetes. Semaglutide produces much larger weight loss, has an obesity approval, and has an outcomes trial in obesity without diabetes; dulaglutide's outcomes trial covered the broader diabetes population. The comparison is a prescribing decision outside what this site covers."}],"references":[{"cite":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial.","where":"Lancet, 2019","url":"https://pubmed.ncbi.nlm.nih.gov/31189511/","note":"9,901 participants; median 5.4 years; HR 0.88."},{"cite":"Dulaglutide (Trulicity) product information and the AWARD clinical programme.","where":"FDA / EMA product information","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/trulicity","note":"Licensed indications and the glucose and weight data behind them."}],"last_reviewed":"2026-09-10","literature_searched_to":"2026-09-10","changelog":[{"date":"2026-09-10","note":"Initial publication. Grade A on REWIND and the AWARD programme."}],"license":"CC BY 4.0 — cite as “LYO Research” with a link.","methodology":"https://lyoresearch.com/methodology"}