Evidence mapPaperPMID 42198407Full record

ReviewPharmaceuticals (Basel, Switzerland)2026

Oral GLP-1-Based Therapeutics in the Obesity-Metabolic Syndrome-Diabetes Continuum: Translational Advances, Clinical Barriers, and Emerging Strategies.

Syed Arman Rabbani, Manita Saini, Mohamed El-Tanani, Rakesh Kumar, Ismail Matalka, Yahia El-Tanani, Shrestha Sharma, Manfredi Rizzo

Abstract readReview
In one paragraph

Review in Pharmaceuticals (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Syed Arman RabbaniClinical Pharmacy & Pharmacology, RAK College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates.ORCID 0000-0002-8454-8158
Manita SainiGeeta Institute of Pharmacy, Geeta University, Panipat 132145, India.ORCID 0009-0000-4157-1166
Mohamed El-TananiClinical Pharmacy & Pharmacology, RAK College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates.
Rakesh KumarAmity Institute of Pharmacy, Amity University, Gurgaon 122413, India.
Ismail MatalkaClinical Pharmacy & Pharmacology, RAK College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates.ORCID 0000-0003-4999-2242
Yahia El-TananiRoyal Cornwall Hospital Trust, National Health Service, Truro TR1 3LJ, UK.
Shrestha SharmaAmity Institute of Pharmacy, Amity University, Gurgaon 122413, India.
Manfredi RizzoClinical Pharmacy & Pharmacology, RAK College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates.ORCID 0000-0002-9549-8504

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The obesity-metabolic syndrome-diabetes continuum is driven by interconnected mechanisms including insulin resistance, dysfunctional adiposity, chronic inflammation and progressive cardio-renal-metabolic injury. This triggered a need for therapies that extend beyond glucose lowering alone. The benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as disease-modifying drugs include weight loss, cardiovascular risk reduction, glycemic control and renal protection. However, treatment burden, adherence issues and access restrictions may limit the long-term effects of injectable formulations. One significant translational development that aims to close this gap is oral GLP-1-based treatments. In this review, we examine the mechanistic rationale, formulation science and clinical development of oral GLP-1 RAs. Oral semaglutide is presented as the first validated proof of concept for systemic peptide delivery by the gastrointestinal route. The biological barriers to oral peptide absorption, including enzymatic degradation, low epithelial permeability, pharmacokinetic variability and epithelial safety constraints, are critically discussed. Enabling technologies such as SNAC-based gastric absorption, nanocarriers, mucoadhesive systems and stability-optimization platforms are evaluated. Evidence from the PIONEER program and related studies demonstrating meaningful glycemic and weight-loss efficacy, acceptable safety and clinical utility in patients with type 2 diabetes and chronic kidney disease is further synthesized. Beyond first-generation oral peptide platforms, we discuss the emerging landscape of non-peptide oral GLP-1 RAs, dual and triple incretin agonists, precision dosing strategies and model-informed drug development. Oral GLP-1-based therapeutics are shifting from a formulation breakthrough to a broader translational strategy for disease modification across the obesity-metabolic syndrome-diabetes continuum. Long-term renal outcomes, access and implementation barriers remain important priorities for future research.

Indexed as

cardiovascularchronic kidney diseaseformulation shiftingGLP-1 RAsinjectablemetabolic syndromeobesityoral peptideoral semaglutidePIONEER programSNACtype 2 diabetes

Identifiers

PMID42198407
PMCPMC13209388

What Socratic holds

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Registered trials

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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.