Evidence mapPaperPMID 41489846Full record

SynthesisEndocrine2026

Exploring the rates of Gastrointestinal adverse effects among five GLP-1 receptor agonists: A systematic review and Meta-Analysis of randomized controlled trials.

Bethany Joy, Anya Ramsamooj, Steven Ibrahim, Jimmy Wen, Neil Hsu, Eldo Frezza

Abstract readSystematic ReviewNetwork Meta-AnalysisMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

6 authors.

Bethany JoyCalifornia Northstate University College of Medicine, California, USA. Bethany.Joy7985@cnsu.edu.ORCID http://orcid.org/0009-0002-5707-146X
Anya RamsamoojCalifornia Northstate University College of Medicine, California, USA.
Steven IbrahimCalifornia Northstate University College of Medicine, California, USA.
Jimmy WenCalifornia Northstate University College of Medicine, California, USA.
Neil HsuCalifornia Northstate University College of Medicine, California, USA.
Eldo FrezzaCalifornia Northstate University College of Medicine, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGlucagon-like peptide 1 receptor agonists (GLP-1 RAs) are effective and commonly used agents in treating type 2 diabetes and obesity. Due to their success in weight loss, usage of this class of medications is becoming more common. Yet any use of GLP-1 RAs does not come without disadvantages. This meta-analysis aimed to analyze the gastrointestinal (GI)-related adverse effects (AEs) of GLP-1 RAs use.

methodsA systematic review search following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was performed in three databases for studies reporting GI AEs after GLP-1 RA usage. A pair-wise meta-analysis evaluating the six most common GI AEs (nausea, vomiting, diarrhea, constipation, decreased appetite, and pancreatitis) among GLP-1 RAs was performed, along with a network meta-analysis comparing semaglutide, liraglutide, exenatide, dulaglutide, and tirzepatide to one another in the context of GI AEs.

results101 randomized controlled studies were included in final analysis, with 41,443 of 57,684 patients receiving one of five GLP-1 RAs: liraglutide (37 studies), semaglutide (28 studies), exenatide (25 studies), dulaglutide (18 studies), and tirzepatide (8 studies). All six GI AEs analyzed were found to have a statistically significant risk ratio compared to placebo, with a 95% confidence interval and p < 0.00001: nausea (RR: 2.90; Incidence: 22.8%), vomiting (3.60; 9.12%), diarrhea (1.97; 13%), constipation (2.41; 7.39%), decreased appetite (3.51; 2.61%), and pancreatitis (2.24; 1.07%). Head-to-head comparisons revealed tirzepatide to carry the highest risk ratios for nausea and diarrhea while semaglutide carries the highest risk ratios for vomiting and constipation.

conclusionsRegardless of the GLP-1 RAs used, it is apparent that GI AEs are significant and highly prevalent. Thus, it is crucial that patients and providers alike are aware of these AEs when considering their use.

Indexed as

Gastrointestinal DiseasesGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsDiabetes Mellitus, Type 2DiarrheaExenatideGlucagon-Like PeptidesHumansImmunoglobulin Fc FragmentsLiraglutideNauseaPancreatitisRandomized Controlled Trials as TopicRecombinant Fusion ProteinsSemaglutideTirzepatidedulaglutideExenatideGlucagon-Like Peptide-1 Receptor AgonistsGlucagon-Like PeptidesHypoglycemic AgentsImmunoglobulin Fc FragmentsLiraglutideRecombinant Fusion ProteinsSemaglutideTirzepatideGLP-1GLP-1 analogueMeta-analysisSystematic reviewWeight management

Identifiers

What Socratic holds

Texttitle and abstract
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.