Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes
Summary
This randomised phase 3 trial compared once-weekly mazdutide (a glucagon and GLP-1 receptor dual agonist) with dulaglutide 1.5 mg in 731 Chinese adults with type 2 diabetes on background oral therapy over 28 weeks. Participants were randomised 1:1:1 to mazdutide 4 mg, mazdutide 6 mg or dulaglutide 1.5 mg.
Both mazdutide doses met non-inferiority and showed superiority to dulaglutide for mean change in HbA1c at week 28 (LS mean differences −0.24% for 4 mg and −0.30% for 6 mg). Weight loss was substantially greater with mazdutide (LS mean treatment differences −3.78% for 4 mg and −5.76% for 6 mg versus dulaglutide; both p<0.0001). More participants on mazdutide achieved the composite endpoint of HbA1c <7.0% plus ≥5% weight reduction. The most common treatment-emergent adverse events were gastrointestinal (diarrhoea, nausea, vomiting); overall safety was acceptable but with a higher rate of GI events versus dulaglutide.
Key Points
- Phase 3, randomised study in 731 Chinese adults with T2D on oral agents, treatment duration 28 weeks.
- Mazdutide 4 mg and 6 mg were both non-inferior and superior to dulaglutide 1.5 mg for HbA1c reduction at week 28 (LS mean differences −0.24% and −0.30%, respectively).
- Mazdutide produced significantly greater weight loss than dulaglutide (−3.78% for 4 mg and −5.76% for 6 mg; both p<0.0001).
- A higher proportion of participants on mazdutide reached HbA1c <7.0% with ≥5% weight loss compared with dulaglutide (both p<0.0001).
- Safety profile was generally acceptable; gastrointestinal adverse events were more frequent with mazdutide (diarrhoea, nausea, vomiting being the commonest).
Why should I read this?
Short version: if you follow diabetes drugs, this one’s a big deal. Mazdutide not only nudges blood sugar down a bit more than dulaglutide but also drives noticeably larger weight loss — and that combo is exactly what clinicians and patients want. We’ve done the heavy lifting and pulled out the headline results so you don’t have to.
Context and relevance
This study adds to mounting evidence that dual-receptor agonists can deliver enhanced metabolic benefits compared with established GLP-1 agonists. The stronger weight-loss effect alongside improved glycaemic control is important for treatment strategies targeting both hyperglycaemia and obesity in people with type 2 diabetes. The trial’s focus on a Chinese population helps inform regional efficacy and safety, which matters for guideline decisions, payer considerations and clinical practice in Asia and beyond.