GIP/GLP-1 & amylin agonists × adverse events & safety

SynthesisAnnals of Saudi medicine

Gastrointestinal safety of semaglutide and tirzepatide vs. placebo in obese individuals without diabetes: a systematic review and meta analysis.

Moaz Safwan et al.PubMed ↗Full text ↗Publisher ↗

  • Both agents (semaglutide and tirzepatide)looks bad hereMore overall GI adverse events.Randomised, small.
  • Tirzepatidelooks bad hereMore overall GI adverse events.Randomised, small.
  • Semaglutidelooks bad hereMore overall GI adverse events.Randomised, small.

What the trial testedrandomised

Randomised vs placebo

Probably increased overall GI adverse events

1.9×1.6× to 2.2×

both agents (semaglutide and tirzepatide) vs placebo

Bigger than 8 in 10 for adverse events & safety

As reported

RR 1.86, 95% CI 1.56–2.21

Randomised vs placebo

Probably increased overall GI adverse events

2.9×2.6× to 3.3×

tirzepatide vs placebo

Bigger than 9 in 10 for adverse events & safety

As reported

RR 2.94, 95% CI 2.61–3.32

Randomised vs placebo

Probably increased overall GI adverse events

+68%+46% to +94%

semaglutide vs placebo

Bigger than 7 in 10 for adverse events & safety

As reported

RR 1.68, 95% CI 1.46–1.94

Who was studied, and how

people with obesity, in this paper

The trial randomly assignedassigned by chance

both agents (semaglutide and tirzepatide)
placebo

Probably increased overall GI adverse events1.9×

randomised

The trial randomly assignedassigned by chance

tirzepatide
placebo

Probably increased overall GI adverse events2.9×

randomised

the abstract, start to end

Overall GI adverse events were 1.86 times higher with *both* agents (95% CI=1.56, 2.21), with tirzepatide showing a greater risk (RR 2.94, 95% CI=2.61, 3.32) than semaglutide (RR 1.68, 95% CI=1.46, 1.94).

← favours treatmentfavours comparator →
could be chance
Overall GI adverse eventsboth agents (semaglutide and tirzepatide) vs placebo
RR 1.861.56–2.21
Overall GI adverse eventstirzepatide vs placebo
RR 2.942.61–3.32
Overall GI adverse eventssemaglutide vs placebo
RR 1.681.46–1.94
GLP-1 receptor agonistsGIP/GLP-1 & amylin agonistsAdverse events & safety

GIP/GLP-1 & amylin agonists × adverse events & safetyharms?mixed

unlikelylikely
0.00not counted

GLP-1 receptor agonists × adverse events & safetyharms?mixed

unlikelylikely
0.02not counted
← favours treatmentfavours comparator →
more certainless certain
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13 papers cite it

2025
2026
pooled itcites it
Full record →Abstract, authors, funding and every citing paper · PMID 40189856