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Research citation

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

Systematic Review And Meta AnalysisStrong evidence

This record provides bibliographic details and links to the original research. An editorial study breakdown is not available.

What the researchers found

Both semaglutide and tirzepatide nearly doubled GI side effects versus placebo. Tirzepatide had higher GI risk (RR 2.94) than semaglutide (RR 1.68). Semaglutide increased gallstone risk 2.6-fold but tirzepatide did not.

Why it matters

With millions using these drugs for weight loss, understanding the distinct GI safety profiles helps clinicians choose the right drug and monitor for specific complications.

The numbers in context

13 RCTs; n=26,894; overall GI RR 1.86 (95% CI 1.56-2.21); tirzepatide GI RR 2.94 (95% CI 2.61-3.32); semaglutide GI RR 1.68 (95% CI 1.46-1.94); semaglutide cholelithiasis RR 2.6 (95% CI 1.40-4.82)

How the study worked

Systematic review and meta-analysis of RCTs comparing semaglutide or tirzepatide to placebo in obese adults without diabetes. Pooled risk ratios for GI, biliary, hepatic, and pancreatic adverse events.

Who was studied

Adults with obesity without diabetes across 13 randomized controlled trials

What this study cannot tell us

Trials had different follow-up durations and doses. Cannot compare semaglutide and tirzepatide directly since they were compared to placebo separately. Limited data on rare events like pancreatic cancer.

Read the original research

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

Annals of Saudi medicine, 45(2), 129-143

Citation

Safwan, Moaz; Bourgleh, Mariam Safwan; Alotaibi, Shahad Abdullah; Alotaibi, Eman; Al-Ruqi, Abdulsalam; El Raeya, Fathiya. (2025). Gastrointestinal safety of semaglutide and tirzepatide vs. placebo in obese individuals without diabetes: a systematic review and meta analysis.. Annals of Saudi medicine, 45(2), 129-143. https://doi.org/10.5144/0256-4947.2025.129