A study in The BMJ shows that adding Mounjaro (tirzepatide) to standard care for type 2 diabetes patients with heart disease reduces heart attack risk by 33% compared to sitagliptin. Analyzing data from 52,971 U.S. patients, researchers found Mounjaro lowered the risk of major adverse cardiovascular events from 4.4% to 2.9% over one year. The drug also reduced infection-related hospitalizations but showed no impact on stroke. NHS spending on tirzepatide reached £574 million last year.
Mounjaro cardiovascular benefits diabetes
- ▪Mounjaro (tirzepatide) is currently used on the National Health Service (NHS) in the United Kingdom to treat both type 2 diabetes and severe obesity
- ▪A linked editorial in The BMJ notes that while the study on tirzepatide provides a transparent estimate of its routine care effects, it does not establish a mortality indication or define the best sequence for cardiometabolic therapy
- ▪Adding the GLP-1 receptor agonist drug tirzepatide (marketed as Mounjaro) to standard care for patients with type 2 diabetes and heart disease is associated with a lower risk of major cardiovascular events
BMJ study methodology
- ▪The BMJ study compared outcomes of patients starting tirzepatide (35,353 individuals) against those starting sitagliptin (17,618 individuals), which was used as a neutral placebo proxy
- ▪Researchers in the BMJ study used propensity score overlap weighting to balance differences between the tirzepatide and sitagliptin groups, taking into account factors such as age, sex, race, body mass index, and previous heart problems
- ▪Researchers analyzed clinical practice data from two U.S. health insurance claims databases between May 2022 and May 2025, involving 52,971 individuals with type 2 diabetes, a body mass index of at least 25, and established heart disease
MACE reduction outcomes
- ▪At one year of treatment, the risk of major adverse cardiovascular events (MACE) was 2.9% in the tirzepatide group compared to 4.4% in the sitagliptin group, representing a 32% relative reduction
- ▪Tirzepatide was associated with lower rates of infections requiring hospital admission, preventing one admission for every 48 patients, and prevented one death from any cause for every 122 patients
- ▪Researchers estimated that for every 70 patients starting tirzepatide, one case of major adverse cardiovascular events (MACE) would be prevented
Heart attack risk reduction
- ▪Tirzepatide was associated with a 33% lower risk of heart attack compared with sitagliptin in patients with type 2 diabetes and heart disease
- ▪The BMJ study found no meaningful or significant difference in the risk of ischemic stroke between patients taking tirzepatide and those taking sitagliptin
NHS prescribing costs
- ▪The National Health Service (NHS) spent £574 million on tirzepatide last year, which accounted for 5% of its total prescribing bill of £11.6 billion
- ▪Manufacturer Eli Lilly reported that worldwide sales of Mounjaro reached £13.8 billion in the first half of 2026, representing a 106% increase compared to the same period in 2025
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