Evidence map›Paper›PMID 39509151›Full record

ArticleJournal of medical Internet research2024

Multifactor Quality and Safety Analysis of Semaglutide Products Sold by Online Sellers Without a Prescription: Market Surveillance, Content Analysis, and Product Purchase Evaluation Study.

Amir Reza Ashraf, Tim Ken Mackey, Róbert György Vida, Győző Kulcsár, János Schmidt, Orsolya Balázs, Bálint Márk Domián, Jiawei Li, Ibolya Csákó, András Fittler

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · 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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Mechanisms of glucagon-like-peptide 1 in the brain beyond metabolic effects.Annals of pediatric endocrinology & metabolism · 2025
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

10 authors.

Amir Reza AshrafDepartment of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary.ORCID 0000-0003-0339-5653
Tim Ken MackeyGlobal Health Program, Department of Anthropology, University of California San Diego, La Jolla, CA, United States.ORCID 0000-0002-2191-7833
Róbert György VidaDepartment of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary.ORCID 0000-0003-1176-0251
Győző KulcsárDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Pécs, Pécs, Hungary.ORCID 0000-0002-4098-1072
János SchmidtInstitute of Biochemistry and Medical Chemistry, Medical School, University of Pécs, Pécs, Hungary.ORCID 0000-0002-3630-9312
Orsolya BalázsDepartment of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary.ORCID 0009-0008-0921-0967
Bálint Márk DomiánDepartment of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary.ORCID 0009-0006-6635-4196
Jiawei LiS-3 Research, San Diego, CA, United States.ORCID 0000-0001-9801-4715
Ibolya CsákóCriminal Department, Criminal Directorate, Hungarian National Police Headquarters, Budapest, Hungary.ORCID 0009-0001-9917-6262
András FittlerDepartment of Pharmaceutics, Faculty of Pharmacy, University of Pécs, Pécs, Hungary.ORCID 0000-0002-8243-6179

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver the past 4 decades, obesity has escalated into a global epidemic, with its worldwide prevalence nearly tripling. Pharmacological treatments have evolved with the recent development of glucagon-like peptide 1 agonists, such as semaglutide. However, off-label use of drugs such as Ozempic for cosmetic weight loss has surged in popularity, raising concerns about potential misuse and the emergence of substandard and falsified products in the unregulated supply chain.

objectiveThis study aims to conduct a multifactor investigation of product quality and patient safety risks associated with the unregulated online sale of semaglutide by examining product availability and vendor characteristics and assessing product quality through test purchases.

methodsWe used a complex risk and quality assessment methodology combining online market surveillance, search engine results page analysis, website content assessment, domain traffic analytics, conducting targeted product test purchases, visual quality inspection of product packaging, microbiological sterility and endotoxin contamination evaluation, and quantitative sample analysis using liquid chromatography coupled with mass spectrometry.

resultsWe collected and evaluated 1080 links from search engine results pages and identified 317 (29.35%) links belonging to online pharmacies, of which 183 (57.7%) led to legal pharmacies and 134 (42.3%) directed users to 59 unique illegal online pharmacy websites. Web traffic data for the period between July and September 2023 revealed that the top 30 domains directly or indirectly affiliated with illegal online pharmacies accumulated over 4.7 million visits. Test purchases were completed from 6 illegal online pharmacies with the highest number of links offering semaglutide products for sale without prescription at the lowest price range. Three injection vial purchases were delivered; none of the 3 Ozempic prefilled injection pens were received due to nondelivery e-commerce scams. All purchased vials were considered probable substandard and falsified products, as visual inspection indicated noncompliance in more than half (59%-63%) of the evaluated criteria. The semaglutide content of samples substantially exceeded labeled amounts by 28.56%-38.69%, although no peptide-like impurities were identified. The lyophilized peptide samples were devoid of viable microorganisms at the time of testing; however, endotoxin was detected in all samples with levels ranging between 2.1645 EU/mg and 8.9511 EU/mg. Furthermore, the measured semaglutide purity was significantly low, ranging between 7.7% and 14.37% and deviating from the 99% claimed on product labels by manufacturers.

conclusionsGlucagon-like peptide 1 agonist drugs promoted for weight loss, similar to erectile dysfunction medications more than 2 decades ago, are becoming the new blockbuster lifestyle medications for the illegal online pharmacy market. Protecting the pharmaceutical supply chain from substandard and falsified weight loss products and raising awareness regarding online medication safety must be a public health priority for regulators and technology platforms alike.

Indexed as

Glucagon-Like PeptidesCommerceHumansInternetSemaglutideGlucagon-Like PeptidesSemaglutidecounterfeitmedication safetynondelivery schemesonline pharmaciesOzempicpatient safetysearch enginessemaglutidesubstandard and falsified medical productsWegovy

Identifiers

PMID39509151
PMCPMC11582493

What Socratic holds

Textmetadata
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.