A once-weekly GLP-1 agonist with cardiovascular benefit — the first GLP-1 to show heart disease risk reduction.
Dulaglutide (Trulicity) is a once-weekly GLP-1 receptor agonist developed by Eli Lilly. It consists of a GLP-1 analog covalently linked to a modified human IgG4 Fc fragment, which extends its half-life to approximately 5 days — enabling once-weekly dosing. The Fc fusion approach is different from semaglutide's fatty acid-albumin binding mechanism.
Dulaglutide was the first GLP-1 agonist to demonstrate cardiovascular benefit in a dedicated outcomes trial (REWIND, 2019). REWIND showed a 12% reduction in major adverse cardiovascular events in type 2 diabetes patients — notably, the trial included a lower-risk population than other GLP-1 CV trials.
Trulicity became one of the most prescribed GLP-1 agents globally before the semaglutide/tirzepatide era. It remains widely used, particularly for patients who prefer its simple autoinjector device.
The REWIND trial demonstrated cardiovascular benefit in a broader population than LEADER (liraglutide) or SUSTAIN-6 (semaglutide) — including patients without established cardiovascular disease. HbA1c reduction averages 1.0-1.5% with weight loss of 3-5 kg.
Dulaglutide produces less weight loss than higher-dose semaglutide or tirzepatide, positioning it as a diabetes-first (rather than obesity-first) GLP-1 option. Its cardiovascular data remains relevant to prescribing decisions.
📚 Key Reference: PMID: 31189511 (REWIND trial)
GI side effects (nausea, diarrhea) are milder than some other GLP-1 agents. Thyroid C-cell tumor warning. Pancreatitis risk. Well-tolerated in clinical practice. Consult your provider.
FDA-approved as Trulicity (Eli Lilly, 2014). Cardiovascular risk reduction indication added after REWIND (2020).