{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:39:40Z","timestamp":1789439980420,"version":"build-2803163510"},"reference-count":32,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the comparative effectiveness of dulaglutide or semaglutide versus tirzepatide on cardiovascular outcomes in adults with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Two target trial emulations included commercially insured adults (June 2022\u2013December 2024) with T2D and ASCVD who initiated subcutaneous tirzepatide, dulaglutide, or semaglutide. The primary outcome was modified major adverse cardiovascular events (MACE), defined as a composite of nonfatal myocardial infarction, nonfatal stroke, and all-cause death. First, new users of tirzepatide and dulaglutide were propensity score (PS) matched one to one. Second, new users of tirzepatide and semaglutide were PS matched one to one. Incidence rates (IRs) per 1,000 person-years and hazard ratios (HRs) were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After PS matching, 9,233 pairs of tirzepatide or dulaglutide initiators and 25,266 pairs of tirzepatide or semaglutide initiators were identified. Tirzepatide initiators experienced a lower rate of modified MACE versus dulaglutide initiators (IR 31.3 vs. 39.4, respectively; HR 0.80 [95% CI 0.65\u20130.99]), which seemed to be driven by lower all-cause mortality among tirzepatide versus dulaglutide initiators (HR 0.60 [95% CI 0.43\u20130.83]). In post hoc analyses, tirzepatide was associated with lower rates of pneumonia-related hospitalization when compared with dulaglutide. Rates of modified MACE were similar among tirzepatide and semaglutide initiators (IR 23.7 vs. 23.2, respectively; HR 1.03 [95% CI 0.90\u20131.17]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Among adults with T2D and ASCVD in routine care, tirzepatide was associated with a lower risk of modified MACE when compared with dulaglutide, driven by reduction in all-cause mortality. Risks of modified MACE seemed similar with tirzepatide and semaglutide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-3063","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:17:39Z","timestamp":1772637459000},"page":"808-817","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Effectiveness of Tirzepatide Versus Dulaglutide or Semaglutide on Major Cardiovascular Events in Type 2 Diabetes and Cardiovascular Disease: Insights From Two Target-Trial Emulations"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2866-9414","authenticated-orcid":false,"given":"John W.","family":"Ostrominski","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"},{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janinne","family":"Ortega-Montiel","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Wexler","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Massachusetts General Hospital and Harvard Medical School 3 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan M.","family":"Everett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital and Harvard Medical School 1 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Cromer","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Massachusetts General Hospital and Harvard Medical School 3 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline F.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Glynn","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Paik","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 2 , Boston, MA"},{"name":"Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 4 , Boston, MA"},{"name":"New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System 5 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Patorno","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School 2 , Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"2026061812465578100_B1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1038\/s41366-024-01473-y","article-title":"What is the pipeline for future medications for obesity?","volume":"49","author":"Melson","year":"2025","journal-title":"Int J Obes (Lond)"},{"key":"2026061812465578100_B2","doi-asserted-by":"crossref","first-page":"620","DOI":"10.7326\/ANNALS-24-02870","article-title":"Trends in utilization of glucose- and weight-lowering medications after tirzepatide approval in the United States: a population-based cohort study","volume":"178","author":"Ostrominski","year":"2025","journal-title":"Ann Intern Med"},{"key":"2026061812465578100_B3","doi-asserted-by":"crossref","first-page":"S181","DOI":"10.2337\/dc25-S009","article-title":"9. 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