Long-term treatment with tirzepatide was associated with greater improvements in physical functioning and weight-related self-perception than dulaglutide in the SURPASS-CVOT trial involving participants with type 2 diabetes mellitus (T2DM) and established atherosclerotic cardiovascular disease (ASCVD). The findings were presented at the AACE Annual Meeting 2026 from a phase 3, double-blind, multicenter cardiovascular outcomes study. 

The event-driven trial randomized 13,299 adults aged 40 years or older with T2DM and ASCVD to once-weekly tirzepatide titrated to the maximum tolerated dose up to 15 mg or dulaglutide 1.5 mg, both added to standard care. Participants had a mean baseline age of 64.1 years, a mean T2DM duration of 14.7 years, a mean glycated hemoglobin (A1C) of 8.4%, and a mean body mass index (BMI) of 32.6 kg/m². A total of 13,165 participants were included in the modified intent-to-treat analysis and followed for a median of 4.0 years.

Health-related quality-of-life outcomes were assessed at week 24 and at months 24 and 48 using the EQ-5D-5L Index, EQ visual analog scale (VAS), Ability to Perform Physical Activities of Daily Living (APPADL), and Impact of Weight on Self-Perceptions (IWSP) measures. Baseline patient-reported outcome scores were similar between treatment groups across all measures.

EQ VAS and IWSP scores improved from baseline at all assessed time points in both treatment groups, although improvements were consistently greater with tirzepatide than dulaglutide (all P<.001). APPADL scores also improved at every time point with tirzepatide (all P<.001). In contrast, no APPADL improvement was observed with dulaglutide at month 24, while worsening was reported at month 48 (P<.001). Improvements in all three measures were greater with tirzepatide than dulaglutide at every assessed time point (all P<.001).

EQ-5D-5L Index scores improved from baseline in both treatment groups at week 24 (both P<.001) and month 24 (both P<.05), with sustained improvement through month 48. However, changes in EQ-5D-5L Index scores did not differ significantly between treatment groups at any time point.

The findings showed that HRQoL improved in both treatment groups despite the presence of longstanding T2DM and established ASCVD, with significant improvements observed with tirzepatide across several patient-reported outcome measures.