SynthesisFrontiers in endocrinology2023

A systematic review of the safety of tirzepatide-a new dual GLP1 and GIP agonist - is its safety profile acceptable?

Zhuqing Meng, Min Yang, Haibo Wen, Su Zhou, Chuan Xiong, Yu Wang

Open access · goldFull text readSystematic Review
In one paragraph

Synthesis in Frontiers in endocrinology, 2023. The graph read 1 number from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. Cited by 15 papers, 1 of them a synthesis that pooled it.

1number the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Hypoglycaemiacomparator not stated · t2dfeeds 2 cells of the map
RR 3.831.19 to 12.3
The overall safety profile of tirzepatide is similar to GLP-1RAs, except for the hypoglycemia (tirzepatide 15mg, pooled RR=3.83, 95% CI [1.19- 12.30], Conclusion: The safety profile of tirzepatide is generally acceptable, similar to GLP-1 RAs.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GIP/GLP-1 & amylin agonists×hypoglycaemia

No readable resultOpen on the map →What to test next →

6 readable studies in this cell: 1 favour the treatment, 3 find no difference, 2 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
0 · no effect
NCT039879191,879 enrolled · 2019
Δ -0.24-0.50 to 0.03
NCT038829701,444 enrolled · 2019
Δ -0.26-0.57 to 0.05
NCT04093752917 enrolled · 2019
Δ -0.47-0.81 to -0.13
NCT0405055342 enrolled · 2020
Δ -0.49-3.64 to 2.67

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

GLP-1 receptor agonists×hypoglycaemia

No readable resultOpen on the map →What to test next →

11 readable studies in this cell: 2 favour the treatment, 3 find no difference, 6 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT018365231,398 enrolled · 2013
IRR 1.311.07 to 1.59
NCT02607306819 enrolled · 2015
Treatment contrast 0.480.35 to 0.68
NCT00393718400 enrolled · 2006
IRR 0.200.12 to 0.35
NCT02152371300 enrolled · 2014
OR 4.172.32 to 7.47
NCT04591626291 enrolled · 2020
OR 4.582.64 to 7.95
NCT05564039282 enrolled · 2022
OR 20.48.40 to 49.8
NCT01620489279 enrolled · 2012
OR 3.942.12 to 7.30

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Appendicitis After Initiation of Tirzepatide.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025
    Article
  13. Article
  14. Tirzepatide-Associated Colonic Ischemia.ACG case reports journal · 2024
    Article
  15. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Zhuqing MengDepartment of Pharmacy, Mianyang Fulin Hospital, Mianyang, Sichuan, China.
Min YangDepartment of Pharmacy, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Haibo WenDepartment of Pharmacy, Mianyang Fulin Hospital, Mianyang, Sichuan, China.
Su ZhouDepartment of Pharmacy, Sichuan GEM Flower Hospital, Chengdu, Sichuan, China.
Chuan XiongDepartment of Pharmacy, Mianyang Fulin Hospital, Mianyang, Sichuan, China.
Yu WangDepartment of Pharmacy, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Sichuan Mianyang 404 Hospital · CNMianyang Central Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

Aims: Tirzepatide is a novel dual glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 receptor agonist (GLP-1 RA). At present, there is no controversy over its effectiveness, but its safety. We conducted a systematic review to assess the safety of tirzepatide. Methods: We searched PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs) of tirzepatide from databases inception to August 28, 2022 and used the Cochrane Systematic Assessment Manual Risk of Bias Assessment Tool (version 5.1) and modified Jadad scale to assess risk of bias. The systematic review was conducted Results: Nine RCTs with a total of 9818 patients were included. The overall safety profile of tirzepatide is similar to GLP-1RAs, except for the hypoglycemia (tirzepatide 15mg, pooled RR=3.83, 95% CI [1.19- 12.30], Conclusion: The safety profile of tirzepatide is generally acceptable, similar to GLP-1 RAs. It is necessary to pay attention to its specific adverse events (hypoglycemia and discontinuation) at high doses (10mg or higher). Nausea, vomiting, diarrhea, discontinuation and injection-site reaction were dose-dependence among specific dose ranges.As the heterogeneity in different studies by interventions, the results may be with biases and the further confirmation is needed. Meanwhile, more well-designed trials are needed to control the confounding factors and ensure adequate sample size.

Indexed as

Diabetes Mellitus, Type 2Gastric Inhibitory PolypeptideGlucagon-Like Peptide 1HypoglycemiaHypoglycemic AgentsDiarrheaHumansNauseaTirzepatideVomitingGastric Inhibitory PolypeptideGlucagon-Like Peptide 1Hypoglycemic AgentsTirzepatidediscontinuationdose-dependencedual glucose-dependent insulinotropic peptide and glucagon-like peptide-1 receptor agonistsafetytirzepatide

Identifiers

PMID37051199
PMCPMC10084319
OpenAlexW4361005353

What Socratic holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.