SURPASS-CVOT
A Study of Tirzepatide Compared with Dulaglutide on Major Cardiovascular Events in Participants with Type 2 Diabetes
Doente / População Intervenção / Exposição Comparação Desfecho
In 13,299 patients with type 2 diabetes and atherosclerotic cardiovascular disease, tirzepatide was non-inferior for major adverse cardiovascular events compared with dulaglutide (HR 0.92, 95.3% CI 0.83-1.01).
N
13 299
Desenho
Active-comparator-controlled, double-blind RCT, non-inferiority
Desfecho
Composite of CV death, myocardial infarction, or stroke (3-point MACE)
Relevância
3
ResultadoPrimary event 12.2% with tirzepatide vs 13.1% with dulaglutide (HR 0.92, 95.3% CI 0.83-1.01; P=0.003 non-inferiority, P=0.09 superiority). Non-inferiority met but not superiority; all-cause mortality lower with tirzepatide.
Nicholls SJ, Pavo I, Bhatt DL, et al. N Engl J Med. 2025;393(24):2409-2420. 10.1056/NEJMoa2505928
Discussão e crítica
Active comparator dulaglutide is itself cardioprotective, so non-inferiority does not establish benefit over placebo and MACE superiority was not met. Favourable metabolic, renal, and mortality signals support tirzepatide as at least as safe as an established GLP-1 agonist in ASCVD.