2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T88d,Risk of non-arteritic anterior ischaemic optic neuropathy (NAION) following exposure to glucagon-like peptide-1 receptor agonists (GLP-1RAs) in people with type 2 diabetes and/or obesity remains unclear. The aim of this study was to investigate NAION incidence across randomised placebo-controlled trials evaluating the GLP-1RAs liraglutide and semaglutide. Pooled safety evaluation of NAION incidence from completed phase II, III and IV randomised placebo-controlled trials that evaluated the six Novo Nordisk-manufactured GLP-1RA products (active ingredients: liraglutide and semaglutide) in people with type 2 diabetes and/or overweight/obesity. Potential NAION cases were identified and categorised based on the likelihood of NAION occurrence (definite, probable, unlikely or not assessable). Definite or probable NAION cases were considered confirmed. This pooled analysis included 96 829 participants (GLP-1RA-treated: n=64 917; placebo-treated: n=31 912) with 205 777 participant-years of observation (PYO) (GLP-1RA-treated: 119 393 PYO; placebo-treated: 86 384 PYO). Across all trials, three confirmed NAION cases were identified in three GLP-1RA-treated participants and five confirmed cases were identified in four placebo-treated participants. In GLP-1RA-treated participants, the incidence of confirmed NAION cases was approximately three cases per 100 000 PYO, while in placebo-treated participants, the incidence was approximately six cases per 100 000 PYO. All ophthalmologist-confirmed cases reported one or more associated risk factors (eg, age >50 years, obesity, smoking, dyslipidaemia, hypertension). Data from randomised placebo-controlled trials with semaglutide and liraglutide do not show an increased incidence of NAION in participants receiving GLP-1RA treatment versus those receiving placebo and, thus, do not suggest a relationship between GLP-1RA use and NAION. Based on data from randomised placebo-controlled trials, exposure to the glucagon-like peptide-1 receptor agonists (GLP-1RA) semaglutide and liraglutide was not associated with an increased incidence of non-arteritic anterior ischaemic optic neuropathy (NAION) relative to placebo.31:Tb6d, Background Risk of non-arteritic anterior ischaemic optic neuropathy (NAION) following exposure to glucagon-like peptide-1 receptor agonists (GLP-1RAs) in people with type 2 diabetes and/or obesity remains unclear. The aim of this study was to investigate NAION incidence across randomised placebo-controlled trials evaluating the GLP-1RAs liraglutide and semaglutide. Methods Pooled safety evaluation of NAION incidence from completed phase II, III and IV randomised placebo-controlled trials that evaluated the six Novo Nordisk-manufactured GLP-1RA products (active ingredients: liraglutide and semaglutide) in people with type 2 diabetes and/or overweight/obesity. Potential NAION cases were identified and categorised based on the likelihood of NAION occurrence (definite, probable, unlikely or not assessable). Definite or probable NAION cases were considered confirmed. Results This pooled analysis included 96 829 participants (GLP-1RA-treated: n=64 917; placebo-treated: n=31 912) with 205 777 participant-years of observation (PYO) (GLP-1RA-treated: 119 393 PYO; placebo-treated: 86 384 PYO). Across all trials, three confirmed NAION cases were identified in three GLP-1RA-treated participants and five confirmed cases were identified in four placebo-treated participants. In GLP-1RA-treated participants, the incidence of confirmed NAION cases was approximately three cases per 100 000 PYO, while in placebo-treated participants, the incidence was approximately six cases per 100 000 PYO. All ophthalmologist-confirmed cases reported one or more associated risk factors (eg, age >50 years, obesity, smoking, dyslipidaemia, hypertension). Conclusion Data from randomised placebo-controlled trials with semaglutide and liraglutide do not show an increased incidence of NAION in participants receiving GLP-1RA treatment versus those receiving placebo and, thus, do not suggest a relationship between GLP-1RA use and NAION. Summary Based on data from randomised placebo-controlled trials, exposure to the glucagon-like peptide-1 receptor agonists (GLP-1RA) semaglutide and liraglutide was not associated with an increased incidence of non-arteritic anterior ischaemic optic neuropathy (NAION) relative to placebo. 32:T782,Obesity is highly prevalent in psoriatic arthritis (PsA) and is associated with worse disease outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly being used for weight loss and diabetes, but their impact on PsA outcomes remains unclear. We aimed to characterize patients with PsA initiating GLP-1RAs and assess longitudinal changes in weight, PsA activity, and cardiometabolic parameters. We conducted a retrospective analysis of patients with PsA who initiated GLP-1RAs. PsA disease activity data and cardiometabolic parameters from clinical visits within one year before and after GLP-1RA initiation, along with demographics and comorbidities, were collected. Forty-eight patients with a median body mass index of 34.9 were included. Significant weight loss was observed posttreatment (-6.43 kg, 95% confidence interval [CI] -9.5 to -2.0; P < 0.0001), with 60% losing ≥5% of their baseline bodyweight. C-reactive protein levels (-1.1 mg/L; P = 0.002), pain scores (-1.0; P = 0.01), and triglyceride levels (-0.35 mmol/L; P = 0.02) decreased significantly. Each 1% reduction in body weight was associated with significant improvements in the Disease Activity in Psoriatic Arthritis score (β = -0.49, 95% CI -0.94 to -0.03), tender joint count (β = -0.18, 95% CI -0.32 to -0.05), EuroQol 5-domain (β = 0.0016, 95% CI 0.008-0.023), low-density lipoprotein cholesterol levels (β = -0.05, 95% CI -0.10 to -0.003), and systolic blood pressure (β = -0.67, 95% CI -1.18 to -0.15). In this real-world study, GLP-1RA therapy in PsA was associated with clinically meaningful weight loss and improvements in systemic inflammation, pain, and cardiometabolic markers. Improvements in psoriatic outcomes were proportional to the degree of weight loss. These findings warrant further investigation in prospective controlled studies to evaluate the role of GLP-1RAs in PsA management and comorbidities.33:Td38, Objective Obesity is highly prevalent in psoriatic arthritis (PsA) and is associated with worse disease outcomes. Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) are increasingly being used for weight loss and diabetes, but their impact on PsA outcomes remains unclear. We aimed to characterize patients with PsA initiating GLP‐1RAs and assess longitudinal changes in weight, PsA activity, and cardiometabolic parameters. Methods We conducted a retrospective analysis of patients with PsA who initiated GLP‐1RAs. PsA disease activity data and cardiometabolic parameters from clinical visits within one year before and after GLP‐1RA initiation, along with demographics and comorbidities, were collected. Results Forty‐eight patients with a median body mass index of 34.9 were included. Significant weight loss was observed posttreatment (−6.43 kg, 95% confidence interval [CI] −9.5 to −2.0; P < 0.0001), with 60% losing ≥5% of their baseline bodyweight. C‐reactive protein levels (−1.1 mg/L; P = 0.002), pain scores (−1.0; P = 0.01), and triglyceride levels (−0.35 mmol/L; P = 0.02) decreased significantly. Each 1% reduction in body weight was associated with significant improvements in the Disease Activity in Psoriatic Arthritis score (β = −0.49, 95% CI −0.94 to −0.03), tender joint count (β = −0.18, 95% CI −0.32 to −0.05), EuroQol 5‐domain (β = 0.0016, 95% CI 0.008–0.023), low‐density lipoprotein cholesterol levels (β = −0.05, 95% CI −0.10 to −0.003), and systolic blood pressure (β = −0.67, 95% CI −1.18 to −0.15). Conclusion In this real‐world study, GLP‐1RA therapy in PsA was associated with clinically meaningful weight loss and improvements in systemic inflammation, pain, and cardiometabolic markers. Improvements in psoriatic outcomes were proportional to the degree of weight loss. These findings warrant further investigation in prospective controlled studies to evaluate the role of GLP‐1RAs in PsA management and comorbidities.

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phase 2 data only.","value_numeric":null},{"paper_doi":"10.1007/s13679-026-00756-x","tag_type":"warning","value":"GIPR cellular localization in human adipose tissue remains contested; tirzepatide adipose effects should not be assumed to act primarily via mature adipocytes.","value_numeric":null},{"paper_doi":"10.1007/s13679-026-00756-x","tag_type":"warning","value":"Most claims about weight-independent WAT remodeling are based on animal or in vitro studies; human mechanistic evidence is largely indirect (circulating biomarkers rather than tissue-level data).","value_numeric":null},{"paper_doi":"10.1007/s13679-026-00756-x","tag_type":"warning","value":"Sex-disaggregated adipose tissue data are largely absent from cited studies, limiting applicability to female patients despite female-predominant bariatric cohorts.","value_numeric":null},{"paper_doi":"10.1007/s13679-026-00756-x","tag_type":"warning","value":"This is a narrative review without systematic search protocol—findings reflect author synthesis and may carry selection bias.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examined obesity-induced pathological remodeling of subcutaneous (scWAT) and visceral (vWAT) white adipose tissue, and synthesized evidence from animal models and human studies on how incretin-based therapies (GLP-1R agonists, dual GLP-1/GIP agonists, triple GLP-1/GIP/glucagon agonists) and bariatric surgery (RYGB, sleeve gastrectomy) influence WAT beyond weight loss across inflammatory, mitochondrial/thermogenic, and endocrine pathways.","key_result":"Both incretin-based therapies and bariatric surgery are associated with changes in WAT inflammatory markers, mitochondrial pathways, and adipokine signaling; however, human tissue-level evidence is heterogeneous and most changes occur alongside weight loss. One key divergence: RYGB upregulated OXPHOS-related transcripts in scWAT at 12 months, while diet-induced weight loss of equivalent magnitude downregulated them—suggesting surgery-specific mitochondrial remodeling. Tirzepatide preclinical data indicate ~30% of insulin sensitization occurs independently of weight loss. Retatrutide achieved >24% body weight reduction at 48 weeks (phase 2), with vWAT transcriptomic evidence of reduced inflammation and restored fatty acid oxidation pathways in mice.","limitations":"- Narrative (non-systematic) design introduces selection bias; most human tissue-level data come from scWAT with sparse paired-depot analyses.\n- Nearly all mechanistic evidence for weight-independent WAT remodeling comes from animal models or in vitro systems; human studies lack weight-matched comparators.\n- Sex-stratified adipose outcomes are rarely reported, limiting generalizability across sexes.","practice_takeaway":"Clinicians should recognize that bariatric surgery and incretin-based therapies likely differ in their adipose tissue effects beyond weight reduction—RYGB shows stronger evidence for mitochondrial remodeling and microbiota-mediated gut–adipose signaling. For patients with post-bariatric weight regain, adjunctive tirzepatide or semaglutide can provide additional metabolic benefit, with tirzepatide showing greater weight reduction than semaglutide in that setting."}},{"doi":"10.1542/peds.2026-077048","pmid":"42692477","title":"Trends in GLP-1 Receptor Agonist Prescriptions for Children Ages 8 to 11 With Obesity: 2019–2026","journal_title":"Pediatrics","journal_issn":"0031-4005","published_at":"2026-09-04T00:00:00.000Z","url":"https://doi.org/10.1542/peds.2026-077048","source_score":244,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-08T06:32:13.161Z","updated_at":"2026-09-08T06:32:13.161Z","tags":[{"paper_doi":"10.1542/peds.2026-077048","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"brand","value":"Saxenda","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"condition","value":"Pediatric Obesity","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"sample_size","value":"n=3520531","value_numeric":3520531},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"study_design","value":"Retrospective Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"warning","value":"Study data run through June 17, 2026; 2026 figures are partial-year estimates and may not reflect full-year trends.","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"warning","value":"The 9.3% figure for 2026 reflects prevalent prescribing within a specific subgroup and timeframe (to June 2026), not the overall cohort rate of 0.6% — context matters when citing these numbers.","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"warning","value":"The impact flag 'safety_signal' was applied because rapid, large-scale prescribing growth in a young age group with limited long-term pediatric safety data warrants monitoring — not because the paper itself reports adverse events.","value_numeric":null},{"paper_doi":"10.1542/peds.2026-077048","tag_type":"warning","value":"Zepbound (tirzepatide) is a dual GIP/GLP-1 receptor agonist, not a pure GLP-1RA; its inclusion alongside Saxenda and Wegovy may slightly broaden the definition of 'GLP-1RA' used in this study.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cross-sectional study of repeated annual cohorts (Epic Cosmos database) examined trends in GLP-1 receptor agonist (GLP-1RA) prescribing for children aged 8–11 with obesity but without diabetes from January 2019 to June 2026 (n = 3,520,531).","key_result":"Only 0.6% of eligible children received a GLP-1RA prescription overall, but prescribing rose 310-fold — from 0.03% in 2019 to 9.3% in 2026 (P < .001). Rates were higher in older children (11 yr: 79.5 vs. 8 yr: 41.5 per 10,000), females (75.9 vs. 42.8 per 10,000), those with comorbidities (188.9 per 10,000), and those with low social vulnerability (76.1 vs. 49.2 per 10,000 for high vulnerability).","limitations":"- Retrospective cross-sectional design cannot establish causation or capture whether prescriptions were filled/used.\n- Epic Cosmos captures only health systems using Epic EHR, potentially limiting generalizability.\n- No data on dosing, duration, or clinical outcomes (e.g., weight loss, adverse events).","practice_takeaway":"GLP-1RAs are being appropriately targeted to higher-risk children (older age, more comorbidities), but children with greater socioeconomic vulnerability are being prescribed them less often — a disparity worth actively addressing in clinical practice."}},{"doi":"10.1038/s41366-026-02189-x","pmid":"42668312","title":"Effects of subcutaneous semaglutide on weight loss and inflammatory markers in adults with overweight or obesity without diabetes: a systematic review and meta-analysis","journal_title":"International Journal of Obesity","journal_issn":"0307-0565","published_at":"2026-08-29T00:00:00.000Z","url":"https://doi.org/10.1038/s41366-026-02189-x","source_score":16,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-08T06:32:01.073Z","updated_at":"2026-09-08T06:32:01.073Z","tags":[{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"condition","value":"Overweight","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"sample_size","value":"n=6239","value_numeric":6239},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"warning","value":"CRP reduction is reported as a percentage change; the absolute baseline CRP values are not provided, which limits clinical interpretation of the inflammatory marker findings.","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"warning","value":"Pooling of trials with different semaglutide doses (including the higher 7.2 mg STEP UP dose) may inflate or add variability to the pooled weight-loss estimate; dose-specific subgroup data are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1038/s41366-026-02189-x","tag_type":"warning","value":"The brand tag defaults to Wegovy (approved subcutaneous semaglutide for obesity); the paper does not explicitly name a brand, so clinicians should verify dose/formulation context.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 9 RCTs (n=6,239) evaluated subcutaneous semaglutide vs. placebo for weight management in adults with overweight or obesity **without** diabetes, examining body weight, waist circumference, CRP, and serious adverse events (SAEs).","key_result":"Semaglutide significantly reduced body weight (MD −12.04%, 95% CI −13.08 to −11.00), waist circumference (MD −9.36 cm, 95% CI −10.27 to −8.45), and CRP (MD −40.90%, 95% CI −46.37 to −35.42) vs. placebo (all p < 0.00001). SAE risk did not differ significantly (RR 1.12, 95% CI 0.76–1.65; p = 0.55).","limitations":"- Long-term efficacy and safety data beyond included trial durations are lacking.\n- Meta-analysis pooled trials of varying semaglutide doses (up to 7.2 mg in STEP UP), which may introduce heterogeneity.\n- Restricted to adults without diabetes, limiting generalizability to broader obesity populations.","practice_takeaway":"Subcutaneous semaglutide produces clinically meaningful weight loss (~12% body weight) and reduces systemic inflammation (CRP −41%) in non-diabetic adults with overweight or obesity, without a significant increase in serious adverse events. Clinicians can use this evidence to support semaglutide prescribing in this population, while awaiting longer-term safety data."}},{"doi":"10.1016/s2213-8587(26)00186-5","pmid":"42660161","title":"From adiposity to multisystem morbidity: the case for weight loss as disease modification","journal_title":"The Lancet Diabetes & Endocrinology","journal_issn":"2213-8587","published_at":"2026-08-28T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-8587(26)00186-5","source_score":16,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-06T06:22:57.417Z","updated_at":"2026-09-06T06:22:57.417Z","tags":[{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Heart Failure With Preserved Ejection Fraction","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Obstructive Sleep Apnoea","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Osteoarthritis","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"modality","value":"GLP-1/GIP Dual Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"modality","value":"Weight Loss Intervention","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"study_design","value":"Systematic Review / Narrative Review","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"warning","value":"Brand name tags (Ozempic, Wegovy, Mounjaro, Zepbound) are inferred from the generic drug names semaglutide and tirzepatide as used in obesity/diabetes contexts; the paper does not explicitly list brand names.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"warning","value":"No specific sample size is reported, as this is a review article synthesising across multiple studies.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"warning","value":"The paper is a narrative review using a triangulation framework — not a formal systematic review or meta-analysis — so the strength of causal inference varies by condition and evidence type.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00186-5","tag_type":"warning","value":"The study design label 'Systematic Review / Narrative Review' reflects a hybrid approach; the authors describe triangulation of multiple evidence types rather than a preregistered systematic methodology.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates whether weight-loss interventions (lifestyle, surgical, and pharmacological — notably semaglutide and tirzepatide) can prevent or modify common obesity-related conditions across musculoskeletal, metabolic, cardiovascular, mental health, respiratory, and hepatic domains, using a triangulation framework of epidemiological, genetic (including Mendelian randomisation), and randomised trial evidence.","key_result":"Robust trial evidence supports weight loss as disease-modifying in type 2 diabetes and heart failure with preserved ejection fraction; incretin-based therapies (semaglutide, tirzepatide) now achieve ~14–20% average weight loss in people without diabetes and have generated the first large-scale randomised evidence of disease modification across several conditions, though many areas (musculoskeletal, respiratory, mental health, cardiovascular) remain under-investigated.","limitations":"- Many conditions lack adequate randomised trial evidence, limiting causal conclusions.\n- Evidence on varying magnitudes of weight loss with different agents, disease-stage effects, and long-term (legacy) outcomes is sparse.\n- Trials have not adequately addressed multimorbidity, mechanistic mediation, diverse global populations, or access equity.","practice_takeaway":"Clinicians have strong evidence to use weight-loss therapies — especially GLP-1 receptor agonists like semaglutide and dual GLP-1/GIP agonists like tirzepatide — for disease modification in type 2 diabetes and HFpEF, but should recognise that evidence for many other obesity-related conditions is still emerging. Individualised treatment targets and long-term follow-up remain important given persistent gaps in outcome data."}},{"doi":"10.1016/s2213-8587(26)00134-8","pmid":"42567173","title":"Effect of semaglutide on kidney outcomes in the SELECT, FLOW, and SOUL trials: a prespecified pooled analysis","journal_title":"The Lancet Diabetes & Endocrinology","journal_issn":"2213-8587","published_at":"2026-08-07T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-8587(26)00134-8","source_score":34,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-13T13:22:57.220Z","updated_at":"2026-08-13T13:22:57.220Z","tags":[{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"brand","value":"Rybelsus","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"condition","value":"Atherosclerotic Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"condition","value":"Cardio-Kidney-Metabolic Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"sample_size","value":"n=30787","value_numeric":30787},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"study_design","value":"Pooled Analysis of Randomized Controlled Trials","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"warning","value":"Industry-funded (Novo Nordisk); potential for sponsorship bias should be considered when interpreting effect sizes.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"warning","value":"The study population spans patients with and without type 2 diabetes, so subgroup-specific benefit estimates are not detailed in the abstract.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00134-8","tag_type":"warning","value":"Three distinct semaglutide formulations and doses were pooled (SC 1.0 mg, SC 2.4 mg, oral 14 mg); effects may not be uniform across all routes and doses.","value_numeric":null}],"summaries":{"what_studied":"Pooled participant-level analysis of three randomized placebo-controlled trials (SELECT, FLOW, SOUL; N=30,787) evaluating semaglutide (subcutaneous 1.0 mg weekly, subcutaneous 2.4 mg weekly, or oral 14 mg daily) versus placebo added to standard of care in adults with CKD or atherosclerotic cardiovascular disease, over a mean follow-up of 39.5–47.5 months.","key_result":"Semaglutide reduced the primary kidney composite (≥50% eGFR decline, kidney failure, kidney-related death, or CV death) vs. placebo: 973 vs. 1,134 first events (HR 0.84, 95% CI 0.77–0.91). The narrower kidney-only composite also favored semaglutide: 347 vs. 416 events (HR 0.80, 95% CI 0.69–0.92). Serious adverse events were numerically lower with semaglutide.","limitations":"- Three different doses and routes of administration were pooled, limiting direct comparability across formulations.\n- Baseline characteristics differed across trials (e.g., diabetes prevalence, CKD severity), which may introduce heterogeneity.\n- Funded by Novo Nordisk, introducing potential industry bias.","practice_takeaway":"Across a broad cardio-kidney-metabolic population—with or without diabetes—semaglutide (oral or injectable) meaningfully reduces major kidney and cardiovascular outcomes with a favorable safety profile. Clinicians should consider semaglutide for kidney protection beyond its glucose-lowering or weight-loss effects alone."}},{"doi":"10.1038/s41574-026-01279-0","pmid":"42481750","title":"Diagnosis, staging and management of obesity: a synthesis of contemporary guidelines","journal_title":"Nature Reviews Endocrinology","journal_issn":"1759-5029","published_at":"2026-07-21T00:00:00.000Z","url":"https://doi.org/10.1038/s41574-026-01279-0","source_score":24,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-24T13:38:12.949Z","updated_at":"2026-07-24T13:38:12.949Z","tags":[{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"brand","value":"Contrave","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"brand","value":"Qsymia","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"brand","value":"Saxenda","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"condition","value":"Obstructive Sleep Apnea","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"condition","value":"Overweight","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"condition","value":"Type 2 Diabetes Mellitus","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"generic","value":"naltrexone/bupropion extended-release","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"generic","value":"phentermine/topiramate extended-release","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"Comprehensive Lifestyle Intervention","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"Endoscopic Sleeve Gastroplasty","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"GIP/GLP-1 Dual Agonist","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"Intragastric Balloon","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"Metabolic/Bariatric Surgery","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"Naltrexone/Bupropion","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"modality","value":"Phentermine/Topiramate","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"warning","value":"Level of evidence '1' reflects CPG status per evidence hierarchy; individual recommendations within the guideline range from high to very low quality evidence per GRADE.","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"warning","value":"Sample size tag was omitted because this is a guideline synthesis, not a single trial with a defined N.","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"warning","value":"The paper's metadata (title, author, PDF properties) identifies this as the VA/DOD 2025 CPG for Overweight and Obesity in Adults, not the Nature Reviews Endocrinology article cited in the DOI and journal fields—there is a mismatch between the provided metadata and the actual document content. Structured extraction is based on the VA/DOD CPG full text.","value_numeric":null},{"paper_doi":"10.1038/s41574-026-01279-0","tag_type":"warning","value":"The 'practice_changing' impact flag was applied because the guideline explicitly moves away from mandatory CLI-first stepped care before pharmacotherapy and lowers the BMI threshold for bariatric surgery (≥30 with T2DM), representing a meaningful shift from prior VA/DOD guidance.","value_numeric":null}],"summaries":{"what_studied":"This is the 2025 VA/DOD Clinical Practice Guideline (CPG) for the Management of Overweight and Obesity in Adults, updated using GRADE methodology based on evidence reviewed through January 2025. It covers diagnosis, staging, and multimodal management—including lifestyle intervention, pharmacotherapy, endoscopic therapy, and metabolic/bariatric surgery—in adult Veterans and active-duty Service members.","key_result":"23 evidence-based recommendations were issued. Key strong recommendations include: (1) offering comprehensive lifestyle intervention (CLI) combining behavioral, dietary, and physical activity components; (2) semaglutide or tirzepatide for weight loss and maintenance in BMI ≥27 kg/m² with comorbidity or BMI ≥30 kg/m² (average weight loss −11.8% and −15% to −21.2%, respectively, vs. placebo). Weak recommendations support metabolic/bariatric surgery (MBS) for BMI ≥35 or BMI ≥30 with T2DM (MBS reduced BMI by 6.01 kg/m² and weight by 17.7% more than lifestyle/medical therapy). Discontinuing obesity medications is weakly advised against, as stopping semaglutide led to +6.9% weight regain vs. −7.9% with continuation (STEP 4); stopping tirzepatide led to +14.0% regain vs. −5.5% (SURMOUNT-4). No specific adiposity measure (beyond BMI) was recommended for or against due to insufficient evidence.","limitations":"Evidence base consists largely of systematic reviews and RCTs with high heterogeneity, short follow-up (often <2 years), and selective trial populations that may not reflect the VA/DOD demographic (e.g., high comorbidity burden, PTSD, combat injuries). No studies directly compared timing of pharmacotherapy initiation relative to CLI. Dose-reduction strategies for obesity medications have no evidence base.","practice_takeaway":"Offer CLI plus semaglutide or tirzepatide to eligible patients (BMI ≥30, or ≥27 with a comorbidity) rather than sequencing lifestyle before medication—there is no evidence supporting a mandatory CLI-first waiting period. Advise patients that stopping obesity medications will likely lead to substantial weight regain, so plan for long-term or lifelong therapy."}},{"doi":"10.14218/jcth.2025.00596","pmid":null,"title":"Comparative Efficacy of Promising Targets in the Treatment of Metabolic Dysfunction-associated Steatotic Liver Disease and Steatohepatitis: A Systematic Review and Network Meta-analysis","journal_title":"Journal of Clinical and Translational Hepatology","journal_issn":"2225-0719","published_at":"2026-07-20T00:00:00.000Z","url":"https://doi.org/10.14218/jcth.2025.00596","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-26T13:44:53.172Z","updated_at":"2026-07-26T13:44:53.172Z","tags":[{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"brand","value":"Rezdiffra","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatohepatitis","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"efruxifermin","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"lanifibranor","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"pegozafermin","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"pioglitazone","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"resmetirom","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"retatrutide","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"ACC Inhibitor","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"FGF21 Analog","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"FXR Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"GLP-1/GCG Dual Receptor Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"GLP-1/GIP Dual Receptor Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"GLP-1/GIP/GCG Triple Receptor Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"PPAR Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"modality","value":"Thyroid Hormone Receptor-Beta Agonist","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"sample_size","value":"n=11410","value_numeric":11410},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"study_design","value":"Systematic Review and Network Meta-Analysis","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"warning","value":"d-(R)-pioglitazone's high SUCRA ranking for fibrosis improvement is based on a single small-biopsy-subset trial (DESTINY-1); CINeMA certainty was very low — this ranking should not be used to drive prescribing.","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"warning","value":"Resmetirom and semaglutide received FDA approval for MASH (F2–F3) after the search cutoff or near it; their SUCRA rankings in this NMA do not reflect their full phase 3 evidence base and should not be interpreted as evidence of inferiority.","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"warning","value":"The impact_flag 'practice_changing' was applied cautiously: while the NMA synthesizes the most current evidence across 11 targets, most active-vs-active comparisons rely on indirect evidence with low-to-very-low CINeMA certainty, and no new therapies received regulatory approval within this paper itself.","value_numeric":null},{"paper_doi":"10.14218/jcth.2025.00596","tag_type":"warning","value":"The paper is dated July 2026, which is beyond the current knowledge cutoff for standard AI training data; content has been extracted solely from the provided full text.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and network meta-analysis compared 11 pharmacologic targets (33 medications) across 44 RCTs (n=11,410 adults) for MASLD/MASH, evaluating fibrosis improvement ≥1 stage without steatohepatitis worsening, steatohepatitis resolution without fibrosis worsening, liver fat content, liver enzymes, metabolic profiles, non-invasive tests, and safety outcomes (search through November 20, 2024).","key_result":"For fibrosis improvement, d-(R)-pioglitazone (OR 4.75, SUCRA 79.3) and FGF21 analogs (OR 3.52, SUCRA 71.9) ranked highest. For steatohepatitis resolution, GLP-1/GIP dual receptor agonists ranked highest (OR 14.33, SUCRA 91.7), followed by GLP-1/GCG dual agonists (OR 10.67). GLP-1/GIP/GCG triple agonists ranked best for relative LFC reduction (mean difference −81.40%). GLP-1 RA and GLP-1/GCG dual RA had significantly higher rates of any AEs vs. placebo; FXR agonists and GLP-1/GCG dual RA had higher discontinuation rates; no target significantly increased SAEs or cardiovascular events.","limitations":"- Most histological evidence came from single trials with small biopsy subsets (especially d-(R)-pioglitazone, based on one 36-week trial), making SUCRA rankings unstable and CINeMA certainty low or very low for most comparisons.\n- Predominantly placebo-centered network with no direct head-to-head comparisons; active-versus-active estimates derived largely from indirect evidence, limiting reliability.\n- Trials excluded cirrhotic (F4) patients and varied widely in duration (16–72 weeks), baseline fibrosis stage, BMI, and metabolic comorbidities, constraining generalizability and transitivity.","practice_takeaway":"Incretin-based co-agonists (particularly GLP-1/GIP dual agonists like tirzepatide) and FGF21 analogs show the most promising signals across liver histology and metabolic endpoints, but certainty of evidence is low to very low and no head-to-head trials exist — treatment choice should still incorporate fibrosis stage, comorbidities, and tolerability. Both FDA-approved agents (resmetirom for F2–F3 MASH, semaglutide for F2–F3 MASH) remain established first-line options supported by larger phase 3 data."}},{"doi":"10.1016/s2468-1253(26)00123-8","pmid":"42456707","title":"Efficacy and safety of zalfermin co-administered with semaglutide in participants with fibrosis and cirrhosis due to metabolic dysfunction-associated steatohepatitis: a phase 2, dose-ranging, double-blind, randomised controlled trial","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-07-16T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(26)00123-8","source_score":109,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:35:53.404Z","updated_at":"2026-07-20T13:35:53.404Z","tags":[{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"condition","value":"Compensated Cirrhosis","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatohepatitis","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"generic","value":"cagrilintide","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"generic","value":"zalfermin","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"modality","value":"Amylin Analogue","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"modality","value":"FGF21 Analogue","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"sample_size","value":"n=698","value_numeric":698},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"warning","value":"Cagrilintide + semaglutide arm was exploratory only — no formal hypothesis testing was planned for this arm.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"warning","value":"One death (heart failure in the zalfermin 30 mg group) was assessed as possibly related to study drug; small numbers limit safety conclusions.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"warning","value":"The semaglutide monotherapy result is nominally significant only (p=0.024 without correction for multiple comparisons); it should not be interpreted as a confirmed treatment effect.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00123-8","tag_type":"warning","value":"Zalfermin is an investigational FGF21 analogue not yet approved; the brand tag 'Wegovy' is assigned to semaglutide 2.4 mg based on the approved dose, though the trial context is investigational.","value_numeric":null}],"summaries":{"what_studied":"This phase 2 RCT evaluated once-weekly subcutaneous zalfermin (7.5 mg, 15 mg, or 30 mg) co-administered with semaglutide 2.4 mg vs. semaglutide alone, zalfermin alone, cagrilintide + semaglutide, or placebo over 52 weeks in 698 adults with biopsy-confirmed MASH and fibrosis stages F2–F4c (including compensated cirrhosis).","key_result":"The primary endpoint — ≥1-stage fibrosis improvement with no MASH worsening at 52 weeks — was not met for zalfermin 30 mg + semaglutide vs. placebo (24% vs. 16%; EDP 7.98, 95% CI −3.82 to 19.79; p=0.19). Semaglutide 2.4 mg alone showed a nominally significant benefit vs. placebo (30% vs. 16%; EDP 14.05, 95% CI 1.88–26.23; p=0.024).","limitations":"- The trial was not powered to show significance for each arm individually, and multiple comparisons limit the strength of the semaglutide finding (nominal p-value only).\n- The 52-week biopsy endpoint may be too short to capture full antifibrotic effects, especially in F4c cirrhosis.\n- Sponsor (Novo Nordisk) funding introduces potential conflicts of interest.","practice_takeaway":"Zalfermin combined with semaglutide did not outperform placebo for fibrosis improvement in MASH — adding zalfermin to semaglutide does not appear beneficial at this stage. Semaglutide 2.4 mg alone showed a nominally significant antifibrotic signal, including in compensated cirrhosis (F4c), and may warrant further evaluation as a disease-modifying therapy in this population."}},{"doi":"10.1136/rmdopen-2025-006577","pmid":"42457215","title":"Psoriatic arthritis and obesity: a review of clinical burden and considerations for comprehensive care","journal_title":"RMD Open","journal_issn":"2056-5933","published_at":"2026-07-15T00:00:00.000Z","url":"https://doi.org/10.1136/rmdopen-2025-006577","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:36:05.406Z","updated_at":"2026-07-20T13:36:05.406Z","tags":[{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Cosentyx","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Taltz","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Metabolic Syndrome","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Psoriasis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"bimekizumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"ixekizumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"secukinumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"GIP/GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"IL-17 Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"sample_size","value":"n=49","value_numeric":49},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"Sample size tag reflects the number of included studies in the narrative review, not a patient-level N.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the TOGETHER-PsA combination therapy signal and the emerging incretin data; clinicians should note that PsA-specific regulatory approvals for GLP-1/GIP RAs are not yet established.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"The TOGETHER-PsA trial (n=271) results cited are from a 2026 publication; full peer-reviewed data should be independently verified as the review appears to have had early access.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"This review was funded by Eli Lilly and Company, and three co-authors are Lilly employees; tirzepatide (a Lilly product) is featured prominently including data from the TOGETHER-PsA trial authored by overlapping investigators.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examined the interplay between psoriatic arthritis (PsA) and obesity, covering shared inflammatory pathways, impact on disease severity and treatment response, weight-management strategies (lifestyle, bariatric surgery, pharmacological), and the potential role of incretin-based therapies (GLP-1 RAs, dual GIP/GLP-1 RAs). Literature search covered PubMed, Embase, and Scopus up to October 2025; 49 studies were included.","key_result":"Obesity (BMI ≥30) worsens PsA severity, reduces biologic response, and raises cardiovascular risk. Key data points: each 1-unit BMI rise in psoriasis patients increases PsA risk by 5.3%; modest weight loss (5–10% body weight) improves disease activity; in one trial, ACR20 response was 71% vs 30% (p=0.008) in patients who lost ≥18.6% weight. The TOGETHER-PsA trial (n=271) found ixekizumab plus tirzepatide achieved ACR50 and ≥10% weight loss at week 36 in 31.7% vs 0.8% with ixekizumab alone (p<0.001), with higher ACR50 rates (33.5% vs 20.4%; p=0.02).","limitations":"- Non-systematic search introduces selection bias despite efforts to prioritize higher-quality evidence.\n- Three authors are Eli Lilly employees and the study was funded by Eli Lilly, raising potential conflict of interest given tirzepatide (Mounjaro/Zepbound) is a Lilly product prominently featured.\n- PsA-specific outcome data for incretin-based therapies remain limited; most cardiovascular and weight-loss data derive from diabetes or general obesity populations.","practice_takeaway":"Treat obesity as a core comorbidity in PsA—screen BMI routinely, integrate weight-management counseling into every rheumatology visit, and consider GLP-1 RA or GIP/GLP-1 RA co-therapy for patients with PsA and obesity who have inadequate response to biologics alone. Multidisciplinary coordination with endocrinology, dietetics, and primary care is recommended by EULAR, GRAPPA, and ACR/NPF guidelines."}},{"doi":"10.1097/aog.0000000000006367","pmid":"42424619","title":"Association of Glucagon-Like Peptide-1 Receptor Agonists With Menstrual Events in Reproductive-Aged Patients","journal_title":"Obstetrics & Gynecology","journal_issn":"0029-7844","published_at":"2026-07-09T00:00:00.000Z","url":"https://doi.org/10.1097/aog.0000000000006367","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-14T13:24:08.905Z","updated_at":"2026-07-14T13:24:08.905Z","tags":[{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"brand","value":"Victoza","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"condition","value":"Menstrual Disorders","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"study_design","value":"Retrospective Pharmacovigilance Study","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"warning","value":"Brand tags include common trade names for semaglutide and tirzepatide but the paper does not specify which formulations were captured in FAERS.","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"warning","value":"Sample size (total N) was not reported in the abstract; tag omitted.","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"warning","value":"The age range 12–55 spans adolescent through perimenopausal women; findings may not apply uniformly across all subgroups.","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006367","tag_type":"warning","value":"The study design is a pharmacovigilance disproportionality analysis — it can identify safety signals but cannot confirm causality or quantify absolute risk.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated the association between GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide) and menstrual adverse events in female patients aged 12–55 years, using FDA Adverse Event Reporting System (FAERS) data through March 2026 via disproportionality and Bayesian analyses.","key_result":"Semaglutide showed the broadest signal profile — disproportionate reporting of heavy menstrual bleeding, intermenstrual bleeding, menstrual clots, oligomenorrhea, and anovulatory cycles. Tirzepatide generated signals for intermenstrual bleeding and menstrual clots. Liraglutide produced no significant signals.","limitations":"Pharmacovigilance data from FAERS are subject to underreporting, reporting bias, and inability to establish causation. Confounders such as underlying conditions (e.g., PCOS, obesity) and concomitant medications cannot be controlled. Signal detection does not confirm incidence or absolute risk.","practice_takeaway":"Clinicians prescribing semaglutide or tirzepatide to reproductive-aged patients should proactively counsel them about potential menstrual changes, including heavy bleeding, intermenstrual bleeding, and cycle irregularities. Consider incorporating menstrual health monitoring into follow-up for patients on these agents."}},{"doi":"10.1136/bmj-2026-372161","pmid":"42419792","title":"Comparative effects of drugs for adults with overweight or obesity: systematic review and network meta-analysis","journal_title":"BMJ","journal_issn":"1756-1833","published_at":"2026-07-08T00:00:00.000Z","url":"https://doi.org/10.1136/bmj-2026-372161","source_score":150,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-12T13:19:47.107Z","updated_at":"2026-07-12T13:19:47.107Z","tags":[{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"brand","value":"Contrave","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"brand","value":"Qsymia","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"brand","value":"Rybelsus","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"condition","value":"Overweight","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"cagrilintide-semaglutide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"ecnoglutide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"mazdutide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"naltrexone-bupropion","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"orforglipron","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"phentermine-topiramate","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"retatrutide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"modality","value":"Amylin/GLP-1 Combination","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"modality","value":"GIP/GLP-1 Dual Agonist","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"modality","value":"Opioid Antagonist/Dopamine-Norepinephrine Reuptake Inhibitor Combination","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"modality","value":"Sympathomimetic/Anticonvulsant Combination","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"sample_size","value":"n=99791","value_numeric":99791},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"study_design","value":"Systematic Review and Network Meta-Analysis","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"warning","value":"Brand name tags are inferred from generic names and common market approvals; the paper itself does not list brand names.","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"warning","value":"CagriSema (cagrilintide-semaglutide) is an investigational combination agent; it is not yet widely approved, and certainty of evidence is moderate.","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"warning","value":"Cardiovascular outcome benefits (mortality, MI) for subcutaneous semaglutide are largely derived from high-risk cardiovascular trial populations and may not apply to the general obesity population.","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"warning","value":"Orforglipron is an oral non-peptide GLP-1 receptor agonist still in late-stage development; its approval status varies by region.","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-372161","tag_type":"warning","value":"The paper's DOI references a 2026 publication date, which is after the current knowledge cutoff for some readers; results include several emerging agents not yet in standard clinical practice.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and network meta-analysis compared 19 drugs for overweight/obesity across 24 outcomes in 262 RCTs (99,791 adults, follow-up 12–172 weeks), using frequentist random effects and Bayesian dose-response models with GRADE certainty ratings.","key_result":"At one year, tirzepatide led weight loss vs. lifestyle modification alone (−14.9%), followed by CagriSema (−14.8%), oral semaglutide (−10.9%), orforglipron (−9.9%), subcutaneous semaglutide (−9.8%), and phentermine-topiramate (−8.1%). Only subcutaneous semaglutide reduced all-cause mortality (RR 0.81, 95% CI 0.72–0.93) and MI (RR 0.72, 0.61–0.85); semaglutide and tirzepatide both reduced heart failure risk. No drug improved quality of life beyond the minimally important difference (10 points; all mean differences <5). Discontinuation due to adverse events was highest with orforglipron (RR 4.2) and fatigue was most marked with naltrexone-bupropion (RR 8.9; +331 per 1,000/year).","limitations":"- Cardiovascular mortality and MI benefits for subcutaneous semaglutide are largely driven by trials in high-risk cardiovascular populations, limiting generalizability to lower-risk groups.\n- Quality-of-life data came from only 43 of 262 trials, potentially underrepresenting important patient-centered outcomes.\n- Emerging agents (ecnoglutide, mazdutide, retatrutide) carry very low to low certainty evidence, restricting firm conclusions.","practice_takeaway":"When choosing an obesity drug, weigh the degree of weight loss against the tolerability profile: tirzepatide and CagriSema offer the greatest weight reduction but carry significant GI and fatigue burdens, while subcutaneous semaglutide is currently the only agent with demonstrated mortality and MI reduction. Shared decision-making should explicitly address trade-offs, as no drug meaningfully improves quality of life beyond placebo."}},{"doi":"10.1016/j.cgh.2026.06.008","pmid":"42309434","title":"Adjunctive GLP1 Receptor Agonists in Patients with Inflammatory Bowel Diseases and Obesity and/or Diabetes: A Target Trial Emulation","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.06.008","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-19T13:23:21.847Z","updated_at":"2026-06-19T13:23:21.847Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"condition","value":"Diabetes","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"condition","value":"Inflammatory Bowel Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"sample_size","value":"n=2374","value_numeric":2374},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"study_design","value":"Target Trial Emulation","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"warning","value":"Brand tags for semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) are inferred from the generic names; the paper does not specify which branded formulations were used.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"warning","value":"Sample size listed reflects the GLP-1RA initiator arms only (2028 + 346); total matched cohort is approximately 4,748 patients — the value_numeric uses the sum of initiators as the labeled 'n' since the abstract leads with these figures.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"warning","value":"The paper's DOI and publication date (June 2026) are future-dated relative to common databases; data integrity assumed as provided.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.008","tag_type":"warning","value":"Tirzepatide is a dual GIP/GLP-1 receptor agonist, not a pure GLP-1RA; its inclusion under the GLP-1RA label follows the authors' own classification.","value_numeric":null}],"summaries":{"what_studied":"This target trial emulation examined whether adding semaglutide or tirzepatide to existing IBD therapy improves 1-year clinical outcomes in stable IBD patients with comorbid obesity and/or diabetes, using U.S. claims data (OptumLabs, 2018–2023) across two cohorts: those on 5-ASA/no IBD therapy (cohort 1, n=4,056 matched pairs) and those on advanced therapies/immunomodulators (cohort 2, n=692 matched pairs).","key_result":"GLP-1RA initiation did not reduce 1-year IBD relapse risk in either cohort. In cohort 1, relapse rates were identical (7.9% vs. 7.9%; RR 1.01, 95% CI 0.82–1.24). In cohort 2, there was a non-significant trend toward lower relapse (12.4% vs. 15.6%; RR 0.80, 95% CI 0.55–1.15). Safety outcomes were similar in both groups. Roughly one-third of patients discontinued GLP-1RAs within 1 year.","limitations":"- Observational claims data cannot confirm actual medication use or adherence; ~33–36% discontinued GLP-1RAs within 1 year, which may dilute any true effect.\n- Relapse defined by administrative codes (hospitalization, surgery, prednisone use) may not capture endoscopic or biomarker-based disease activity.\n- Cohort 2 was relatively small (n=346 per arm), leaving the study underpowered to detect modest treatment effects (CI spans 0.55–1.15).","practice_takeaway":"Clinicians can reassure stable IBD patients that starting semaglutide or tirzepatide for obesity or diabetes does not appear to worsen disease control. However, GLP-1RAs should not yet be prescribed with the expectation of improving IBD outcomes, as no benefit was demonstrated."}},{"doi":"10.1111/jocd.70967","pmid":null,"title":"Alopecia Risk With\n GLP\n ‐1 Receptor Agonists: A Disproportionality Analysis Using the\n FDA\n Adverse Event Reporting System (\n FAERS\n )","journal_title":"Journal of Cosmetic Dermatology","journal_issn":"1473-2130","published_at":"2026-06-07T00:00:00.000Z","url":"https://doi.org/10.1111/jocd.70967","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-14T13:34:52.694Z","updated_at":"2026-06-14T13:34:52.694Z","tags":[{"paper_doi":"10.1111/jocd.70967","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"condition","value":"Alopecia","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"condition","value":"Diabetes Mellitus","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"albiglutide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"dulaglutide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"exenatide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"lixisenatide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"sample_size","value":"n=697","value_numeric":697},{"paper_doi":"10.1111/jocd.70967","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"study_design","value":"Pharmacovigilance / Disproportionality Analysis","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"warning","value":"Brand tags (Ozempic, Wegovy, Mounjaro) are inferred from the generic drugs studied and not explicitly named in the abstract.","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"warning","value":"Disproportionality signals from FAERS do not establish causation; confounding by weight loss-induced telogen effluvium cannot be excluded.","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"warning","value":"The sample size tag reflects only semaglutide alopecia reports (n=697); total FAERS records reviewed across all 7 GLP-1 RAs is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1111/jocd.70967","tag_type":"warning","value":"Tirzepatide is a dual GIP/GLP-1 receptor agonist, not a pure GLP-1 RA; its inclusion in the GLP-1 RA class may warrant a caveat in clinical interpretation.","value_numeric":null}],"summaries":{"what_studied":"Disproportionality analysis of FAERS data (2016–2025) examining the association between 7 GLP-1 receptor agonists (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide, tirzepatide) and alopecia-related adverse events.","key_result":"Semaglutide had the most alopecia reports (n=697) and showed a statistically significant disproportionality signal in 2022 (ROR=1.43, 95% CI: 1.15–1.77) and 2024 (ROR=1.55, 95% CI: 1.35–1.77); 25% of semaglutide reports documented positive dechallenge and 18% positive rechallenge.","limitations":"FAERS data are subject to under-reporting, duplicate entries, and missing confounders (e.g., weight loss itself as a cause of hair loss); causality cannot be established from disproportionality analyses alone.","practice_takeaway":"Clinicians prescribing semaglutide or other GLP-1 RAs should counsel patients about a potential alopecia risk and monitor for hair loss, particularly given rechallenge data suggesting a drug-related effect."}},{"doi":"10.1016/j.annonc.2026.04.013","pmid":"42252247","title":"GLP-1 receptor agonist use and cancer risk in obese nondiabetic adults","journal_title":"Annals of Oncology","journal_issn":"0923-7534","published_at":"2026-06-07T00:00:00.000Z","url":"https://doi.org/10.1016/j.annonc.2026.04.013","source_score":68,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-13T15:34:36.018Z","updated_at":"2026-06-13T15:34:36.018Z","tags":[{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"condition","value":"Obesity-Associated Cancer","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"sample_size","value":"n=161798","value_numeric":161798},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"study_design","value":"Target Trial Emulation (Retrospective Cohort Study)","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"warning","value":"Brand names (Ozempic, Wegovy, Mounjaro, Zepbound) are inferred from the generic drugs listed (semaglutide, tirzepatide); the paper does not explicitly name these brands.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously — the authors themselves call for prospective trials to confirm causality; clinical uptake should await further validation.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"warning","value":"The lack of OAC risk reduction in Black patients is noted but not mechanistically explained in the abstract; clinicians should interpret subgroup findings with caution given potential small sample sizes.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.04.013","tag_type":"warning","value":"The study uses a target trial emulation design from a US claims/EHR database (TriNetX); unmeasured confounders (e.g., lifestyle factors, cancer screening rates) may bias results.","value_numeric":null}],"summaries":{"what_studied":"This target trial emulation evaluated whether GLP-1 receptor agonist (GLP-1RA) use reduces the risk of 13 obesity-associated cancers (OACs) in obese, nondiabetic adults without prior OAC, comparing GLP-1RA users to those receiving diet/exercise counseling, with a median follow-up of 2 years.","key_result":"After 1:1 propensity score matching (n=161,798), GLP-1RA users had a significantly lower incidence of any OAC compared to diet/exercise controls (HR 0.59, 95% CI 0.53–0.67); the benefit was consistent across most subgroups except Black patients.","limitations":"- Median follow-up was only 2 years, which may be too short to capture cancer development and cannot establish long-term risk reduction.\n- Observational design (target trial emulation) limits causal inference; residual confounding is possible despite propensity score matching.\n- The lack of benefit in Black patients is unexplained and warrants further study, as this subgroup may be underrepresented.","practice_takeaway":"GLP-1RAs may offer meaningful short-term cancer risk reduction in obese, nondiabetic patients — a potential benefit worth discussing alongside weight management goals. Prospective trials are still needed before this finding changes prescribing practice."}},{"doi":"10.1097/aog.0000000000006325","pmid":"42208070","title":"Gestational Weight Gain and Pregnancy Outcomes After Semaglutide Exposure","journal_title":"Obstetrics & Gynecology","journal_issn":"0029-7844","published_at":"2026-05-28T00:00:00.000Z","url":"https://doi.org/10.1097/aog.0000000000006325","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-09T13:50:12.158Z","updated_at":"2026-06-09T13:50:12.158Z","tags":[{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"condition","value":"Excessive Gestational Weight Gain","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"condition","value":"Gestational Diabetes","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"condition","value":"Obesity in Pregnancy","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"condition","value":"Preterm Birth","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"sample_size","value":"n=3433","value_numeric":3433},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"warning","value":"Semaglutide brand context (weight-loss vs. diabetes indication) is not distinguished — results may reflect indication bias despite propensity matching.","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"warning","value":"The sample size for pregnancy-exposed users (n=429) is relatively small; estimates for rarer outcomes (e.g., intrauterine growth restriction, preterm birth) may be underpowered.","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"warning","value":"The study does not report statistically significant findings for all outcomes (e.g., preterm birth, pregnancy-related hypertension); only outcomes with significant associations are highlighted in the abstract.","value_numeric":null},{"paper_doi":"10.1097/aog.0000000000006325","tag_type":"warning","value":"Total cohort N (3,433) is derived by summing reported subgroups; the paper does not explicitly state this as the full analytic sample.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study examined gestational weight gain and pregnancy outcomes (gestational diabetes, preterm birth, excessive fetal growth, cesarean delivery, etc.) in individuals with prepregnancy overweight or obesity, comparing semaglutide pregnancy-exposed users, former users (discontinued before pregnancy), and nonusers — using propensity score-matched data from a national EHR/pharmacy-linked dataset (Truveta), with deliveries between January 2022 and January 2026.","key_result":"Both pregnancy-exposed users and former users had significantly worse outcomes vs. nonusers: excessive gestational weight gain (aOR 2.88 and 1.98), gestational diabetes (aOR 1.59 and 1.43), excessive fetal growth (aOR 1.78 and 1.54), and cesarean delivery (aOR 3.35 and 3.92), respectively. No significant differences were found between pregnancy-exposed and former users, suggesting a rebound effect after discontinuation rather than direct fetal harm.","limitations":"- Retrospective observational design limits causal inference; residual confounding cannot be excluded.\n- Semaglutide exposure was captured via pharmacy dispensing data, so actual adherence and dose during pregnancy are uncertain.\n- Median in-pregnancy exposure was only 44 days, limiting conclusions about longer or higher-dose exposures.","practice_takeaway":"Counsel patients using semaglutide who become or plan to become pregnant that stopping the medication before conception may not fully eliminate risks of excessive weight gain, gestational diabetes, or cesarean delivery — likely due to rebound weight effects after discontinuation. Weight management strategies after semaglutide cessation should be addressed proactively in preconception counseling."}},{"doi":"10.1016/s2213-8587(26)00100-2","pmid":"42208956","title":"Beyond weight loss: multisystem benefits of obesity medications","journal_title":"The Lancet Diabetes & Endocrinology","journal_issn":"2213-8587","published_at":"2026-05-28T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-8587(26)00100-2","source_score":136,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:35:52.381Z","updated_at":"2026-07-20T13:35:52.381Z","tags":[{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Contrave","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Qsymia","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Rybelsus","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Saxenda","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Binge-Eating Disorder","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Neurodegenerative Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Obstructive Sleep Apnoea","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Osteoarthritis","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Polycystic Ovary Syndrome","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Substance Use Disorder","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"amycretin","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"cagrilintide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"mazdutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"naltrexone-bupropion","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"phentermine-topiramate","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"retatrutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"survodutide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"modality","value":"Combination Sympathomimetic/Anticonvulsant","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"modality","value":"GIP/GLP-1 Dual Agonist","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"modality","value":"Opioid Antagonist/Antidepressant Combination","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"warning","value":"PCOS is noted in the abstract to have been recently renamed 'polyendocrine metabolic ovarian syndrome' — clinicians may need to search under both terms in other databases.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"warning","value":"Several investigational agents (survodutide, mazdutide, retatrutide, amycretin) were not approved as of the paper's publication date (May 2026); regulatory status may have changed.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"warning","value":"Sex data for included trial populations are not reported in the abstract; tags default to mixed given the broad multi-condition scope.","value_numeric":null},{"paper_doi":"10.1016/s2213-8587(26)00100-2","tag_type":"warning","value":"This is a narrative review, not a systematic review or meta-analysis — the level of evidence (LOE 3) reflects synthesis quality rather than underlying trial quality, which varies widely by comorbidity.","value_numeric":null}],"summaries":{"what_studied":"This review synthesises evidence from RCTs and high-quality meta-analyses on approved and late-stage obesity medications — including phentermine-topiramate, naltrexone-bupropion, GLP-1 receptor agonists (liraglutide, semaglutide), and newer multiagonists (tirzepatide, survodutide, retatrutide, cagrilintide-semaglutide, amycretin) — evaluating their effects across 13+ obesity-related comorbidities beyond weight loss itself.","key_result":"GLP-1-based and multiagonist therapies show beneficial effects across a broad range of comorbid conditions — including type 2 diabetes, MASLD, chronic kidney disease, heart failure, cardiovascular disease, obstructive sleep apnoea, PCOS, osteoarthritis, depression, and binge-eating and substance use disorders — with accumulating evidence that some benefits are independent of weight loss.","limitations":"As a narrative review, it does not perform a systematic meta-analysis; head-to-head comparisons between agents are largely absent; many comorbidity-specific findings come from secondary endpoints of trials not primarily powered for those outcomes.","practice_takeaway":"When selecting an obesity medication, clinicians should consider the patient's full comorbidity profile — not just expected weight loss — as GLP-1-based therapies offer pleiotropic benefits (e.g., cardiovascular, renal, hepatic, neuropsychiatric) that may differ meaningfully across agents.\n\nWeight-loss-independent effects of GLP-1 receptor agonists are now supported by enough evidence to factor into shared decision-making for patients with heart failure, CKD, OSA, or mood disorders."}},{"doi":"10.1097/dss.0000000000005176","pmid":"42210891","title":"The Role of Glucagon-Like Peptide-1 Receptor Agonists in Hair Loss: Clinical Evidence and Proposed Mechanisms","journal_title":"Dermatologic Surgery","journal_issn":"1076-0512","published_at":"2026-05-18T00:00:00.000Z","url":"https://doi.org/10.1097/dss.0000000000005176","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-04T13:23:42.968Z","updated_at":"2026-06-04T13:23:42.968Z","tags":[{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"condition","value":"Alopecia","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"condition","value":"Androgenic Alopecia","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"condition","value":"Inflammatory Alopecia","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"condition","value":"Telogen Effluvium","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"study_design","value":"Scoping Review","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"warning","value":"Brand name tags for semaglutide and tirzepatide are inferred from common clinical knowledge; the abstract does not explicitly list brand names.","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"warning","value":"Study design classification as 'Scoping Review' is based on the abstract's explicit description; no further methodological details were available to confirm rigor.","value_numeric":null},{"paper_doi":"10.1097/dss.0000000000005176","tag_type":"warning","value":"The full article text was not accessible — only the abstract and a publisher permissions page were provided. Specific study counts, patient numbers, effect sizes, and cited references could not be verified from the source.","value_numeric":null}],"summaries":{"what_studied":"This scoping review evaluated the prevalence and mechanisms of alopecia associated with GLP-1 receptor agonists (GLP-1RAs), comparing effects across agents and hair loss types, using PubMed literature published up to April 2026.","key_result":"Evidence links GLP-1RAs — especially tirzepatide and semaglutide — to telogen effluvium and androgenic alopecia, with risk potentially higher at longer durations, greater weight loss, and higher doses. A smaller body of evidence suggests GLP-1RAs may *improve* inflammatory alopecia in patients with metabolic dysfunction.","limitations":"- Scoping review design limits causal inference; no pooled quantitative data or meta-analysis.\n- Full text of the article was not available for extraction — only the abstract was substantive; specific study counts, patient numbers, and effect sizes could not be verified.\n- Conflicting evidence across included studies makes definitive conclusions difficult.","practice_takeaway":"Counsel patients starting GLP-1RAs — particularly tirzepatide or semaglutide — about the risk of telogen effluvium and androgenic alopecia, especially with rapid or significant weight loss. Proactive monitoring and early treatment referral are reasonable in at-risk patients."}},{"doi":"10.1136/bjo-2025-328729","pmid":"42049287","title":"Non-arteritic anterior ischaemic optic neuropathy incidence in placebo-controlled clinical trials of liraglutide or semaglutide","journal_title":"British Journal of Ophthalmology","journal_issn":"0007-1161","published_at":"2026-04-29T00:00:00.000Z","url":"https://doi.org/10.1136/bjo-2025-328729","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-01","doi":"10.1136/bjo-2025-328729","days":"14","issn":"0007-1161","rank":"3","field":"Clinical Medicine","score":"15","category":"Ophthalmology","categories":["Ophthalmology"],"_categories":["Ophthalmology"]},"pubmed":{"doi":"10.1136/bjo-2025-328729","title":"Non-arteritic anterior ischaemic optic neuropathy incidence in placebo-controlled clinical trials of liraglutide or semaglutide.","journal":"The British journal of ophthalmology","methods":"","results":"This pooled analysis included 96 829 participants (GLP-1RA-treated: n=64 917; placebo-treated: n=31 912) with 205 777 participant-years of observation (PYO) (GLP-1RA-treated: 119 393 PYO; placebo-treated: 86 384 PYO). Across all trials, three confirmed NAION cases were identified in three GLP-1RA-treated participants and five confirmed cases were identified in four placebo-treated participants. In GLP-1RA-treated participants, the incidence of confirmed NAION cases was approximately three cases per 100 000 PYO, while in placebo-treated participants, the incidence was approximately six cases per 100 000 PYO. All ophthalmologist-confirmed cases reported one or more associated risk factors (eg, age >50 years, obesity, smoking, dyslipidaemia, hypertension).","abstract":"$30","keywords":["Optic Nerve"],"pubmed_id":"42049287","conclusions":"Data from randomised placebo-controlled trials with semaglutide and liraglutide do not show an increased incidence of NAION in participants receiving GLP-1RA treatment versus those receiving placebo and, thus, do not suggest a relationship between GLP-1RA use and NAION.","publication_date":"2026-04-29T00:00:00"},"crossref":{"DOI":"10.1136/bjo-2025-328729","URL":"https://doi.org/10.1136/bjo-2025-328729","ISSN":["0007-1161","1468-2079"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.1136/bjo-2025-328729","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"bjo-2025-328729","type":"journal-article","issue":null,"score":1,"title":["Non-arteritic anterior ischaemic optic neuropathy incidence 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Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"sample_size","value":"n=48","value_numeric":48},{"paper_doi":"10.1002/art.70170","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"warning","value":"Brand tags (Ozempic, Wegovy, Mounjaro, Zepbound) are inferred from the generic drugs used; the paper does not specify which branded formulations were prescribed.","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"warning","value":"No randomized control arm; improvements could reflect regression to the mean, concurrent DMARD optimization, or natural disease fluctuation rather than GLP-1RA effects.","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"warning","value":"Some outcome measures (e.g., DAPSA, EQ-5D, HAQ-DI) had notably small sub-sample sizes (n=18–26), which may reduce reliability of those specific regression estimates.","value_numeric":null},{"paper_doi":"10.1002/art.70170","tag_type":"warning","value":"Study population had low baseline skin psoriasis burden (median BSA 0%), so dermatologic efficacy cannot be assessed from these data.","value_numeric":null}],"summaries":{"what_studied":"Retrospective analysis of 48 patients with psoriatic arthritis (PsA; median BMI 34.9) who initiated GLP-1 receptor agonists (semaglutide or tirzepatide), comparing PsA disease activity, cardiometabolic markers, and patient-reported outcomes at visits within one year before vs. after GLP-1RA initiation (median follow-up ~208 days).","key_result":"GLP-1RA therapy produced median weight loss of 6.43 kg (P < 0.0001); 60% lost ≥5% of baseline weight. CRP fell by 1.1 mg/L (P = 0.002), pain scores by 1.0 point (P = 0.01), and triglycerides by 0.35 mmol/L (P = 0.02). Each 1% weight loss was independently linked to lower DAPSA score (β = −0.49), tender joint count (β = −0.18), LDL cholesterol (β = −0.05 mmol/L), and systolic BP (β = −0.67 mmHg).","limitations":"- Small sample (n = 48) from only two centers with heterogeneous baseline disease activity, limiting generalizability.\n- No control group; observational design cannot separate GLP-1RA-specific effects from weight-loss effects or concurrent DMARD changes.\n- Short follow-up (~7 months) and minimal baseline skin psoriasis burden precluded assessment of dermatologic outcomes or long-term durability.","practice_takeaway":"In obese PsA patients, adding a GLP-1RA may improve joint activity, inflammation, and cardiometabolic risk in proportion to weight lost — consider it as an adjunct, especially when obesity or diabetes is already an indication. Prospective controlled trials are needed before routine use specifically for PsA disease control."}},{"doi":"10.1001/jama.2026.2615","pmid":"41926100","title":"Medicare Spending Implications for Semaglutide Under Voluntary Price Agreements","journal_title":"JAMA","journal_issn":"0098-7484","published_at":"2026-04-02T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13047485/","source_score":459,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-07","doi":"10.1001/jama.2026.2615","days":"7","issn":"0098-7484","rank":"5","field":"Clinical Medicine","score":"459","category":"Medicine, General & Internal","categories":["Medicine, General & Internal"],"_categories":["Medicine, General & Internal"]},"pubmed":{"doi":"10.1001/jama.2026.2615","title":"Medicare Spending Implications for Semaglutide Under Voluntary Price Agreements.","journal":"JAMA","methods":"","results":"","abstract":"This study compares expected total Medicare spending on semaglutide in 2027 under voluntary price agreement participation vs nonparticipation and estimates beneficiaries eligible for expanded obesity-indication coverage whose treatment costs could be offset with savings from the agreement.","keywords":[],"pubmed_id":"41926100","conclusions":"","publication_date":"2026-04-02T00:00:00"},"crossref":{"DOI":"10.1001/jama.2026.2615","URL":"https://doi.org/10.1001/jama.2026.2615","ISSN":["0098-7484"],"link":[{"URL":"https://jamanetwork.com/journals/jama/articlepdf/2847333/jama_dusetzina_2026_ld_260011_1776721430.18732.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1442","type":"journal-article","issue":"16","score":1,"title":["Medicare Spending Implications for Semaglutide Under Voluntary Price Agreements"],"author":[{"given":"Stacie B.","family":"Dusetzina","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}]},{"given":"Grace","family":"Castle","sequence":"additional","affiliation":[{"name":"Vanderbilt University, Nashville, Tennessee"}]},{"given":"Jihye","family":"Han","sequence":"additional","affiliation":[{"name":"Vanderbilt University, Nashville, Tennessee"}]},{"given":"Ashley A.","family":"Leech","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}]},{"given":"Jinyi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}]}],"issued":{"date-parts":[[2026,4,28]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"335","created":{"date-time":"2026-04-02T15:30:15Z","timestamp":1775143815000,"date-parts":[[2026,4,2]]},"indexed":{"date-time":"2026-04-29T20:40:43Z","timestamp":1777495243362,"date-parts":[[2026,4,29]]},"subject":[],"abstract":"This study compares expected total Medicare spending on semaglutide in 2027 under voluntary price agreement participation vs nonparticipation and estimates beneficiaries eligible for expanded obesity-indication coverage whose treatment costs could be offset with savings from the agreement.","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jama/fullarticle/2847333"}},"subtitle":[],"deposited":{"date-time":"2026-04-28T15:00:29Z","timestamp":1777388429000,"date-parts":[[2026,4,28]]},"issn-type":[{"type":"print","value":"0098-7484"}],"published":{"date-parts":[[2026,4,28]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":null,"key":"jld260011r1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"President Donald J. Trump announces major developments in bringing most-favored-nation pricing to American patients. Published November 6, 2025. Accessed December 31, 2025. https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"jld260011r2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Centers for Medicare & Medicaid Services. CMS launches voluntary model to expand access to life-changing medicines, promote healthier living. Published December 23, 2025. Accessed December 31, 2025. https://www.cms.gov/newsroom/press-releases/cms-launches-voluntary-model-expand-access-life-changing-medicines-promote-healthier-living","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"jld260011r3","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Centers for Medicare & Medicaid Services. Medicare Drug Price Negotiation Program: negotiated prices for initial price applicability year 2027. Published November 2025. Accessed December 31, 2025. https://www.cms.gov/files/document/fact-sheet-negotiated-prices-ipay-2027.pdf","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"jld260011r4","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Centers for Medicare & Medicaid Services. Monthly prescription drug plan formulary and pharmacy network information. 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Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) model: request for applications: manufacturer. Published December 2025. 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