Mounjaro and heart health: key results from the SURPASS-CVOT trial

Mounjaro is a once-weekly injectable medication that targets two key hormones — GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) — to help regulate blood sugar, reduce appetite, and support weight loss. It is already recognised for its effectiveness in managing type 2 diabetes and obesity, and new data suggests it may also offer cardiovascular protection.

Just when you thought the potential benefits of Mounjaro couldn’t get any better, Eli Lilly, the manufacturer of Mounjaro, has unveiled impressive new findings from the SURPASS-CVOT trial. This groundbreaking study evaluated cardiovascular outcomes in adults with type 2 diabetes and established atherosclerotic cardiovascular disease—a high-risk group where cardiovascular disease remains the leading cause of death.

The SURPASS-CVOT trial compared Mounjaro (tirzepatide)—a dual GIP/GLP-1 receptor agonist—with Trulicity (dulaglutide), a GLP-1 receptor agonist that had already demonstrated heart protection in the REWIND1 study. The primary aim? To prove that Mounjaro’s cardiovascular protection was at least non-inferior to Trulicity’s, while exploring any additional benefits.

What makes this study so unique? It was the first head-to-head cardiovascular outcome trial of its kind, spanning 4 and a half years, enrolling more than 13,000 participants across 30 countries, and representing the largest and longest trial of tirzepatide to date. And the results did not disappoint.

• Non-inferior and slightly superior results: Mounjaro demonstrated non-inferiority to Trulicity in reducing major cardiovascular events—including heart attack, stroke, and cardiovascular death. In addition, it showed an 8% lower risk for such events when compared with Trulicity.
• Reduction in all-cause mortality: Patients on Mounjaro saw a 16% reduction in risk of death from any cause versus those on Trulicity.
• Added benefits: Beyond cardiovascular outcomes, Mounjaro also delivered greater weight loss and superior A1C (blood sugar) control, making it a compelling choice for holistic diabetes management.

1. Stronger clinical value for Mounjaro
   These results elevate Mounjaro beyond its current use in glycaemic control and weight management, reinforcing its role in cardiometabolic health for patients with type 2 diabetes and at cardiovascular risk.
2. Expansion in sight
   With this compelling evidence, Eli Lilly is expected to seek approval for expanded use, potentially adding an indication of cardiovascular protection by 2026.
3. Market leadership strengthened
   Already outpacing similar treatments within the marketplace, Mounjaro’s success in SURPASS-CVOT could further solidify its dominance in the GLP-1/GIP dual agonist market.

The SURPASS-CVOT trial confirms that Mounjaro is not just another weight management/diabetes drug—it’s a potential game changer in reducing cardiovascular risk, improving survival, and delivering real metabolic benefits. With better weight management and glycaemic control, this dual-acting medication is shaping the future of diabetes care. As regulatory approvals loom, patients and clinicians should watch closely—this could redefine best practice for managing patients with type 2 diabetes and an increased cardiovascular risk.

REWIND trial (Lancet abstract)