Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes – Nature

Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes – Nature

ByWirePaw

Abstract

Mazdutide is a once-weekly glucagon and glucagon-like peptide-1 receptor dual agonist developed for the treatment of type 2 diabetes (T2D) 1. This study assessed the efficacy and safety of mazdutide versus dulaglutide in participants with T2D on background oral anti-diabetic drugs. In this randomised phase 3 study, 731 participants with T2D were randomised 1:1:1 to receive mazdutide 4 mg, mazdutide 6 mg or dulaglutide 1.5 mg for 28 weeks. Both mazdutide doses demonstrated non-inferiority and superiority to dulaglutide 1.5 mg in mean change in HbA1c from baseline to week 28, with the least squares (LS) mean treatment difference of −0.24% (p=0.0032) for mazdutide 4 mg and −0.30% (p=0.0003) for mazdutide 6 mg vs dulaglutide 1.5 mg. Significantly greater weight reductions were achieved with mazdutide versus dulaglutide, with LS mean treatment difference of −3.78% for mazdutide 4 mg and −5.76% for mazdutide 6 mg vs dulaglutide (both p<0.0001). Moreover, significantly more participants with mazdutide achieved the composite endpoint of HbA1c <7.0% with ≥5% weight reduction vs dulaglutide 1.5 mg at week 28 (both p<0.0001). The most common treatment-emergent adverse events were diarrhoea, nausea, and vomiting. Our findings showed that 28-week treatment with mazdutide (4 mg and 6 mg) provided superior reductions in HbA1c and body weight compared with dulaglutide 1.5 mg in Chinese participants with T2D. Mazdutide was generally safe, with a higher incidence of gastrointestinal adverse events than dulaglutide.

.readcube-buybox { display: none !important;}

This is a preview of subscription content, access via your institution

Access options

/* style specs start */

/* style specs end */

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

/* style specs start */
style {
display: none !important;
}
.LiveAreaSection * {
align-content: stretch;
align-items: stretch;
align-self: auto;
animation-delay: 0s;
animation-direction: normal;
animation-duration: 0s;
animation-fill-mode: none;
animation-iteration-count: 1;
animation-name: none;
animation-play-state: running;
animation-timing-function: ease;
azimuth: center;
backface-visibility: visible;
background-attachment: scroll;
background-blend-mode: normal;
background-clip: borderBox;
background-color: transparent;
background-image: none;
background-origin: paddingBox;
background-position: 0 0;
background-repeat: repeat;
background-size: auto auto;
block-size: auto;
border-block-end-color: currentcolor;
border-block-end-style: none;
border-block-end-width: medium;
border-block-start-color: currentcolor;
border-block-start-style: none;
border-block-start-width: medium;
border-bottom-color: currentcolor;
border-bottom-left-radius: 0;
border-bottom-right-radius: 0;
border-bottom-style: none;
border-bottom-width: medium;
border-collapse: separate;
border-image-outset: 0s;
border-image-repeat: stretch;
border-image-slice: 100%;
border-image-source: none;
border-image-width: 1;
border-inline-end-color: currentcolor;
border-inline-end-style: none;
border-inline-end-width: medium;
border-inline-start-color: currentcolor;
border-inline-start-style: none;
border-inline-start-width: medium;
border-left-color: currentcolor;
border-left-style: none;
border-left-width: medium;
border-right-color: currentcolor;
border-right-style: none;
border-right-width: medium;
border-spacing: 0;
border-top-color: currentcolor;
border-top-left-radius: 0;
border-top-right-radius: 0;
border-top-style: none;
border-top-width: medium;
bottom: auto;
box-decoration-break: slice;
box-shadow: none;
box-sizing: border-box;
break-after: auto;
break-before: auto;
break-inside: auto;
caption-side: top;
caret-color: auto;
clear: none;
clip: auto;
clip-path: none;
color: initial;
column-count: auto;
column-fill: balance;
column-gap: normal;
column-rule-color: currentcolor;
column-rule-style: none;
column-rule-width: medium;
column-span: none;
column-width: auto;
content: normal;
counter-increment: none;
counter-reset: none;
cursor: auto;
display: inline;
empty-cells: show;
filter: none;
flex-basis: auto;
flex-direction: row;
flex-grow: 0;
flex-shrink: 1;
flex-wrap: nowrap;
float: none;
font-family: initial;
font-feature-settings: normal;
font-kerning: auto;
font-language-override: normal;
font-size: medium;
font-size-adjust: none;
font-stretch: normal;
font-style: normal;
font-synthesis: weight style;
font-variant: normal;
font-variant-alternates: normal;
font-variant-caps: normal;
font-variant-east-asian: normal;
font-variant-ligatures: normal;
font-variant-numeric: normal;
font-variant-position: normal;
font-weight: 400;
grid-auto-columns: auto;
grid-auto-flow: row;
grid-auto-rows: auto;
grid-column-end: auto;
grid-column-gap: 0;
grid-column-start: auto;
grid-row-end: auto;
grid-row-gap: 0;
grid-row-start: auto;
grid-template-areas: none;
grid-template-columns: none;
grid-template-rows: none;
height: auto;
hyphens: manual;
image-orientation: 0deg;
image-rendering: auto;
image-resolution: 1dppx;
ime-mode: auto;
inline-size: auto;
isolation: auto;
justify-content: flexStart;
left: auto;
letter-spacing: normal;
line-break: auto;
line-height: normal;
list-style-image: none;
list-style-position: outside;
list-style-type: disc;
margin-block-end: 0;
margin-block-start: 0;
margin-bottom: 0;
margin-inline-end: 0;
margin-inline-start: 0;
margin-left: 0;
margin-right: 0;
margin-top: 0;
mask-clip: borderBox;
mask-composite: add;
mask-image: none;
mask-mode: matchSource;
mask-origin: borderBox;
mask-position: 0 0;
mask-repeat: repeat;
mask-size: auto;
mask-type: luminance;
max-height: none;
max-width: none;
min-block-size: 0;
min-height: 0;
min-inline-size: 0;
min-width: 0;
mix-blend-mode: normal;
object-fit: fill;
object-position: 50% 50%;
offset-block-end: auto;
offset-block-start: auto;
offset-inline-end: auto;
offset-inline-start: auto;
opacity: 1;
order: 0;
orphans: 2;
outline-color: initial;
outline-offset: 0;
outline-style: none;
outline-width: medium;
overflow: visible;
overflow-wrap: normal;
overflow-x: visible;
overflow-y: visible;
padding-block-end: 0;
padding-block-start: 0;
padding-bottom: 0;
padding-inline-end: 0;
padding-inline-start: 0;
padding-left: 0;
padding-right: 0;
padding-top: 0;
page-break-after: auto;
page-break-before: auto;
page-break-inside: auto;
perspective: none;
perspective-origin: 50% 50%;
pointer-events: auto;
position: static;
quotes: initial;
resize: none;
right: auto;
ruby-align: spaceAround;
ruby-merge: separate;
ruby-position: over;
scroll-behavior: auto;
scroll-snap-coordinate: none;
scroll-snap-destination: 0 0;
scroll-snap-points-x: none;
scroll-snap-points-y: none;
scroll-snap-type: none;
shape-image-threshold: 0;
shape-margin: 0;
shape-outside: none;
tab-size: 8;
table-layout: auto;
text-align: initial;
text-align-last: auto;
text-combine-upright: none;
text-decoration-color: currentcolor;
text-decoration-line: none;
text-decoration-style: solid;
text-emphasis-color: currentcolor;
text-emphasis-position: over right;
text-emphasis-style: none;
text-indent: 0;
text-justify: auto;
text-orientation: mixed;
text-overflow: clip;
text-rendering: auto;
text-shadow: none;
text-transform: none;
text-underline-position: auto;
top: auto;
touch-action: auto;
transform: none;
transform-box: borderBox;
transform-origin: 50% 50%0;
transform-style: flat;
transition-delay: 0s;
transition-duration: 0s;
transition-property: all;
transition-timing-function: ease;
vertical-align: baseline;
visibility: visible;
white-space: normal;
widows: 2;
width: auto;
will-change: auto;
word-break: normal;
word-spacing: normal;
word-wrap: normal;
writing-mode: horizontalTb;
z-index: auto;
-webkit-appearance: none;
-moz-appearance: none;
-ms-appearance: none;
appearance: none;
margin: 0;
}
.LiveAreaSection {
width: 100%;
}
.LiveAreaSection .login-option-buybox {
display: block;
width: 100%;
font-size: 17px;
line-height: 30px;
color: #222;
padding-top: 30px;
font-family: Harding, Palatino, serif;
}
.LiveAreaSection .additional-access-options {
display: block;
font-weight: 700;
font-size: 17px;
line-height: 30px;
color: #222;
font-family: Harding, Palatino, serif;
}
.LiveAreaSection .additional-login > li:not(:first-child)::before {
transform: translateY(-50%);
content: “”;
height: 1rem;
position: absolute;
top: 50%;
left: 0;
border-left: 2px solid #999;
}
.LiveAreaSection .additional-login > li:not(:first-child) {
padding-left: 10px;
}
.LiveAreaSection .additional-login > li {
display: inline-block;
position: relative;
vertical-align: middle;
padding-right: 10px;
}
.BuyBoxSection {
display: flex;
flex-wrap: wrap;
flex: 1;
flex-direction: row-reverse;
margin: -30px -15px 0;
}
.BuyBoxSection .box-inner {
width: 100%;
height: 100%;
padding: 30px 5px;
display: flex;
flex-direction: column;
justify-content: space-between;
}
.BuyBoxSection p {
margin: 0;
}
.BuyBoxSection .readcube-buybox {
background-color: #f3f3f3;
flex-shrink: 1;
flex-grow: 1;
flex-basis: 255px;
background-clip: content-box;
padding: 0 15px;
margin-top: 30px;
}
.BuyBoxSection .subscribe-buybox {
background-color: #f3f3f3;
flex-shrink: 1;
flex-grow: 4;
flex-basis: 300px;
background-clip: content-box;
padding: 0 15px;
margin-top: 30px;
}
.BuyBoxSection .subscribe-buybox-nature-plus {
background-color: #f3f3f3;
flex-shrink: 1;
flex-grow: 4;
flex-basis: 100%;
background-clip: content-box;
padding: 0 15px;
margin-top: 30px;
}
.BuyBoxSection .title-readcube,
.BuyBoxSection .title-buybox {
display: block;
margin: 0;
margin-right: 10%;
margin-left: 10%;
font-size: 24px;
line-height: 32px;
color: #222;
text-align: center;
font-family: Harding, Palatino, serif;
}
.BuyBoxSection .title-asia-buybox {
display: block;
margin: 0;
margin-right: 5%;
margin-left: 5%;
font-size: 24px;
line-height: 32px;
color: #222;
text-align: center;
font-family: Harding, Palatino, serif;
}
.BuyBoxSection .asia-link,
.Link-328123652,
.Link-2926870917,
.Link-2291679238,
.Link-595459207 {
color: #069;
cursor: pointer;
text-decoration: none;
font-size: 1.05em;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 1.05em6;
}
.BuyBoxSection .access-readcube {
display: block;
margin: 0;
margin-right: 10%;
margin-left: 10%;
font-size: 14px;
color: #222;
padding-top: 10px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection ul {
margin: 0;
}
.BuyBoxSection .link-usp {
display: list-item;
margin: 0;
margin-left: 20px;
padding-top: 6px;
list-style-position: inside;
}
.BuyBoxSection .link-usp span {
font-size: 14px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .access-asia-buybox {
display: block;
margin: 0;
margin-right: 5%;
margin-left: 5%;
font-size: 14px;
color: #222;
padding-top: 10px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .access-buybox {
display: block;
margin: 0;
margin-right: 10%;
margin-left: 10%;
font-size: 14px;
color: #222;
opacity: 0.8px;
padding-top: 10px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .price-buybox {
display: block;
font-size: 30px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
padding-top: 30px;
text-align: center;
}
.BuyBoxSection .price-buybox-to {
display: block;
font-size: 30px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
text-align: center;
}
.BuyBoxSection .price-info-text {
font-size: 16px;
padding-right: 10px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .price-value {
font-size: 30px;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .price-per-period {
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .price-from {
font-size: 14px;
padding-right: 10px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .issue-buybox {
display: block;
font-size: 13px;
text-align: center;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 19px;
}
.BuyBoxSection .no-price-buybox {
display: block;
font-size: 13px;
line-height: 18px;
text-align: center;
padding-right: 10%;
padding-left: 10%;
padding-bottom: 20px;
padding-top: 30px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .vat-buybox {
display: block;
margin-top: 5px;
margin-right: 20%;
margin-left: 20%;
font-size: 11px;
color: #222;
padding-top: 10px;
padding-bottom: 15px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 17px;
}
.BuyBoxSection .tax-buybox {
display: block;
width: 100%;
color: #222;
padding: 20px 16px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: NaNpx;
}
.BuyBoxSection .button-container {
display: flex;
padding-right: 20px;
padding-left: 20px;
justify-content: center;
}
.BuyBoxSection .button-container > * {
flex: 1px;
}
.BuyBoxSection .button-container > a:hover,
.Button-505204839:hover,
.Button-1078489254:hover,
.Button-2737859108:hover {
text-decoration: none;
}
.BuyBoxSection .btn-secondary {
background: #fff;
}
.BuyBoxSection .button-asia {
background: #069;
border: 1px solid #069;
border-radius: 0;
cursor: pointer;
display: block;
padding: 9px;
outline: 0;
text-align: center;
text-decoration: none;
min-width: 80px;
margin-top: 75px;
}
.BuyBoxSection .button-label-asia,
.ButtonLabel-3869432492,
.ButtonLabel-3296148077,
.ButtonLabel-1636778223 {
display: block;
color: #fff;
font-size: 17px;
line-height: 20px;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
text-align: center;
text-decoration: none;
cursor: pointer;
}
.Button-505204839,
.Button-1078489254,
.Button-2737859108 {
background: #069;
border: 1px solid #069;
border-radius: 0;
cursor: pointer;
display: block;
padding: 9px;
outline: 0;
text-align: center;
text-decoration: none;
min-width: 80px;
max-width: 320px;
margin-top: 20px;
}
.Button-505204839 .btn-secondary-label,
.Button-1078489254 .btn-secondary-label,
.Button-2737859108 .btn-secondary-label {
color: #069;
}
.uList-2102244549 {
list-style: none;
padding: 0;
margin: 0;
}
.article-buy-button {
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto, Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
color: #069;
}
/* style specs end */

Similar content being viewed by others

Author information

Author notes

  1. These authors contributed equally: Lixin Guo, Bo Zhang

  2. A complete list of the investigators in the DREAMS-2 trial is provided in the Supplementary Information

Authors and Affiliations

  1. Department of Endocrinology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, <City>, P.R. China

    Lixin Guo

  2. China-Japan Friendship Hospital, Beijing, China

    Bo Zhang & Wenying Yang

  3. Central Hospital Affiliated to Shandong First Medical University, Jinan, China

    Xia Xue

  4. Genertec Liaoyou Gem Flower Hospital, Panjin, China

    Xin Zhang

  5. The Second Norman Bethune Hospital of Jilin University, Changchun, China

    Hanqing Cai

  6. The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China

    Hongwei Jiang

  7. Jincheng General Hospital, Jincheng, China

    Lili Zhang

  8. The Third Xiangya Hospital of Central South University, Changsha, China

    Ping Jin

  9. Yuncheng Central Hospital, Yuncheng, China

    Xiaojing Wang

  10. The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

    Zhifeng Cheng

  11. The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Suhe Zhang

  12. Hengshui People’s Hospital (Harrison International Peace Hospital), Hengshui, China

    Jianlin Geng

  13. The Affiliated Hospital of Bei-hua University, Jilin, China

    Yushan Guo

  14. Innovent Biologics, Inc, Suzhou, China

    Hanbo Hu, Qingyang Ma, Li Li, Haiwei Du, Han Han-Zhang, Fengtai Xue, Huan Deng & Lei Qian

Authors

  1. Lixin Guo
    View author publications

    Search author on:PubMed Google Scholar

  2. Bo Zhang
    View author publications

    Search author on:PubMed Google Scholar

  3. Xia Xue
    View author publications

    Search author on:PubMed Google Scholar

  4. Xin Zhang
    View author publications

    Search author on:PubMed Google Scholar

  5. Hanqing Cai
    View author publications

    Search author on:PubMed Google Scholar

  6. Hongwei Jiang
    View author publications

    Search author on:PubMed Google Scholar

  7. Lili Zhang
    View author publications

    Search author on:PubMed Google Scholar

  8. Ping Jin
    View author publications

    Search author on:PubMed Google Scholar

  9. Xiaojing Wang
    View author publications

    Search author on:PubMed Google Scholar

  10. Zhifeng Cheng
    View author publications

    Search author on:PubMed Google Scholar

  11. Suhe Zhang
    View author publications

    Search author on:PubMed Google Scholar

  12. Jianlin Geng
    View author publications

    Search author on:PubMed Google Scholar

  13. Yushan Guo
    View author publications

    Search author on:PubMed Google Scholar

  14. Hanbo Hu
    View author publications

    Search author on:PubMed Google Scholar

  15. Qingyang Ma
    View author publications

    Search author on:PubMed Google Scholar

  16. Li Li
    View author publications

    Search author on:PubMed Google Scholar

  17. Haiwei Du
    View author publications

    Search author on:PubMed Google Scholar

  18. Han Han-Zhang
    View author publications

    Search author on:PubMed Google Scholar

  19. Fengtai Xue
    View author publications

    Search author on:PubMed Google Scholar

  20. Huan Deng
    View author publications

    Search author on:PubMed Google Scholar

  21. Lei Qian
    View author publications

    Search author on:PubMed Google Scholar

  22. Wenying Yang
    View author publications

    Search author on:PubMed Google Scholar

Consortia

DREAMS-2 investigators

Corresponding author

Correspondence to
Wenying Yang.

Supplementary information

Supplementary Information

This Supplementary Information file contains: Supplementary Methods; A complete list of the investigators in the DREAMS-2 trial; Ethics statement; Supplementary Tables 1-5; and Statistical Analysis Plan.

Reporting Summary

Supplementary Information

Clinical Protocol

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guo, L., Zhang, B., Xue, X. et al. Mazdutide versus dulaglutide in Chinese adults with type 2 diabetes.
Nature (2025). https://doi.org/10.1038/s41586-025-10031-z

Download citation

  • Received: 16 June 2025

  • Accepted: 09 December 2025

  • Published: 17 December 2025

  • DOI: https://doi.org/10.1038/s41586-025-10031-z

Similar Posts