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Dulaglutide
Trulicity
Dulaglutide is a once-weekly GLP-1 receptor agonist developed by Eli Lilly, marketed under the brand name Trulicity. It consists of a GLP-1 analog covalently linked to a modified IgG4 Fc fragment, extending its half-life to approximately 5 days. It is FDA-approved for the treatment of type 2 diabetes mellitus with demonstrated cardiovascular benefit.
Mechanism of Action
GLP-1 receptor agonist fused to a modified IgG4 Fc fragment for extended duration. Weekly dosing improves compliance.
Research Protocols
For research purposes only. Not medical advice.
Research protocols use 0.75mg weekly, escalating to 1.5mg weekly after 4 weeks. Maximum studied dose is 4.5mg weekly.
Research Notes
Clinical Research Status
Dulaglutide received FDA approval in 2014 for type 2 diabetes and has been studied in the extensive AWARD clinical trial program spanning multiple comparator studies. The REWIND cardiovascular outcomes trial demonstrated a 12% reduction in MACE in a broad population including primary prevention patients. It is not currently approved for weight management as a standalone indication.
Key Published Findings
The AWARD trials showed HbA1c reductions of 0.8-1.6% depending on comparator and population studied. REWIND was notable for enrolling a majority of patients without established cardiovascular disease, demonstrating broader preventive benefit. Weight loss in diabetes trials averaged 1.5-3 kg, modest compared to newer GLP-1 agonists optimized for obesity.
Safety Profile
Gastrointestinal adverse events (nausea, diarrhea, vomiting) are the most common side effects, occurring in 15-25% of patients during titration. The same class-wide MTC boxed warning applies, based on rodent thyroid C-cell tumor findings. Injection site reactions are generally mild, and the pre-filled pen device has high patient satisfaction scores.
Comparison to Related Compounds
Compared to semaglutide, dulaglutide produces less weight loss and slightly less HbA1c reduction but uses a simpler auto-injector device that some patients prefer. Its large molecular size (approximately 63 kDa) prevents oral bioavailability, unlike semaglutide which has an oral formulation. Relative to liraglutide, the weekly dosing of dulaglutide offers significant convenience advantage with comparable efficacy.
Community Observations
Trulicity's pen device is frequently cited as one of the most user-friendly among injectable GLP-1 agonists, requiring no needle handling. Patients transitioning from dulaglutide to semaglutide for greater weight loss often report stronger GI side effects initially. Some endocrinologists continue prescribing dulaglutide for patients who prioritize injection simplicity and have modest weight loss goals.
Half Life
~5 days
Reconstitution
Pre-filled pen (no reconstitution)
Storage
Lyophilized
Refrigerate 2-8C. Do not freeze.
Reconstituted
Room temperature up to 14 days if needed.
US Legal Status
Also Known As
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