Comparison of Trulicity and Actos for Diabetes Mellitus

Mechanism of Action and Efficacy

The American Diabetes Association recommends thiazolidinediones, such as Actos, which function as insulin sensitizers in peripheral tissues and have high glucose-lowering efficacy, particularly in patients with type 2 diabetes 2
Trulicity, a GLP-1 receptor agonist, provides superior glycemic control compared to Actos, with a reduction in HbA1c levels, and is beneficial for patients with established atherosclerotic cardiovascular disease 1, 2

The European Society of Cardiology recommends against the use of thiazolidinediones, such as Actos, in patients with heart failure due to increased risk, and suggests alternative treatments like GLP-1 receptor agonists 4, 2
Trulicity has demonstrated cardiovascular benefits, reducing major adverse cardiovascular events with a hazard ratio of 0.88, and is recommended for patients with high cardiovascular risk 1, 3

Actos is associated with fluid retention, edema, and increased risk of heart failure, as well as an increased risk of fractures, particularly in women, and should be used with caution 4, 2
The American College of Cardiology recommends considering the cardiovascular risk profile of the patient when choosing between Trulicity and Actos, as Trulicity offers cardiovascular benefits while Actos increases heart failure risk 1, 4

The American Diabetes Association and European Association for the Study of Diabetes recommend GLP-1 receptor agonists, such as Trulicity, as preferred second-line therapy after metformin for patients with established atherosclerotic cardiovascular disease 6, 7
The European Heart Journal suggests that SGLT2 inhibitors are preferred for patients with heart failure or chronic kidney disease, while GLP-1 receptor agonists have specific places in therapy 4, 6