Pairwise meta-analysis

Systolic blood pressure change

Overweight or obesity without diabetes (adults)

weeks 20 to 40 (target week 26)Hypothetical (as if everyone stayed on treatment)Doses of a drug pooledMean difference

Randomized trials

Treatments

274

Participants

Trial arms

In plain language

Across 2 trials with 274 participants, 1 of 1 treatment had a clearly better result than standard care or no added treatment on systolic blood pressure change. The most favorable estimate was for Tirzepatide injection: mean difference -7.70 mmHg (95% credible interval -13.98 to -0.46).

Lower values favor the treatment. "Clearly" means the 95% credible interval excludes no difference. These are averages across trials; they do not say how any one person will respond. Not medical advice.

Network of trials

Each circle is a treatment; each line joins treatments that were randomized against each other in at least one trial.

Node area shows participants; line width shows trials comparing two treatments directly. Blue: GLP-1 receptor agonist containing treatments; grey: comparators. Hover over or tab to a node or line for details.

Effects compared with Standard care or no added treatment

Mean difference in mmHg. Lower values favor the treatment.

Versus Standard care or no added treatment. Blue: Bayesian random effects posterior median with 95% credible interval (thick) and 95% prediction interval (dashed). Amber diamond: frequentist estimate with 95% confidence interval. Hover over or tab to a row for its values.

Effects of each treatment versus Standard care or no added treatment
Treatment	Bayesian MD (95% CrI)	95% prediction interval	Frequentist MD (95% CI)	Verdict
Tirzepatide injection TIRZ_SC	-7.70 (-13.98 to -0.46)	-18.24 to 3.58	-7.77 (-10.07 to -5.47)	Better

Ranking

How likely each treatment is to be among the best. Rankings ignore the size of differences and their certainty, so read them with the effects above.

Heterogeneity, fit and convergence

Bayesian random effects (primary)

Heterogeneity (tau): 2.290 (95% CrI 0.086 to 10.606)
Residual deviance: 2.7 for 3 data points
DIC: 5.3 (pD 2.6)
Largest R-hat: 1.002
Smallest ESS: bulk 1,832, tail 1,690
Divergent transitions: 0
Convergence: All criteria met
Priors: PR01 N(0, 60^2); PR03 N(0, 30^2); PR07 half normal(0, 6^2) on tau

Frequentist check (netmeta)

Method: inverse variance, REML, MD
Tau: 0.000
I squared: 0%
Q (total): 0.47 on 1 df, P = 0.492

Inconsistency

Do trials comparing two treatments directly agree with the indirect evidence through other treatments?

No comparison here has both direct and indirect evidence, so inconsistency cannot be checked by node splitting.

Small study effects

A comparison adjusted funnel plot: each point is one trial comparison, centered on its own network estimate. Asymmetry can signal that small trials with unfavorable results are missing.

Fewer than ten trial comparisons, too few to judge funnel plot asymmetry.

Baseline characteristics of the trials

The baseline value of each effect modifier or prognostic factor that applies here, per trial: mean or percent over arms, weighted by the number randomized. A note under a value names a stand in (a median for a mean, 100 minus the male share, Asian subgroup rows, an all Asian site list); "not reported" means no source of the trial prints it.

Baseline effect modifiers and prognostic factors per trial
Trial	Baseline BMI or body weight (kg/m2) effect modifier, prognostic factor; 2 of 2
TOGETHER-PsA S001889	37.65
TOGETHER-PsO S000032	39.25

Comparability of the trials

Checked across designs (the set of treatments each trial compares) for eligibility, outcome definition and assessment, and the baseline factors above. Flags point to possible intransitivity; notes describe variation that is not tied to design.

FlagHeterogeneity, tau above threshold: tau 2.29 exceeds the outcome threshold 2; the flags of this network are candidate explanations
NoteOutcome assessment, intercurrent events (rescue): mixed: hypothetical 1, not stated 1
NoteRisk of bias, blinding: mixed: open_label 1, single_blind 1

Comparability items per trial
Trial	adjudicated	time weeks	analysis set	definition	instrument	proportion method	intercurrent events (discontinuation)	intercurrent events (rescue)	blinding	funding	start year	Eligibility
TOGETHER-PsA	not stated	36	modified_itt	not stated	not stated	not stated	hypothetical	hypothetical	single_blind	industry	2024	age 18 to 80; active psoriatic arthritis; BMI 30 or more, or 27 to 30 with a weight related comorbidity
TOGETHER-PsO	not stated	36	modified_itt	not stated	not stated	not stated	hypothetical	not stated	open_label	industry	2024	adults; moderate to severe plaque psoriasis; PASI 12 or more; BMI 30 or more, or 27 to 30 with comorbidity

Trial data

What each trial contributes. Arm rows give the arm value with its standard error, or events over participants; contrast rows give the mean difference on the analysis scale against the trial's first row. Flags mark converted, combined or approximated inputs.

Trial data entering this analysis
Trial	Arm	Treatment	Week	Data	Value	SE	Events / N	Source
TOGETHER-PsO	A1	STANDARD_CARE	36	arm, change	-1.400	1.150	136	R0014237:Table 2
TOGETHER-PsO	A2	TIRZ_SC	36	arm, change	-9.900	1.090	138	R0014237:Table 2
TOGETHER-PsA	A1	STANDARD_CARE	36	contrast, md				R0018951:Table 2
TOGETHER-PsA	A2	TIRZ_SC	36	contrast, md	-6.880	1.747		R0018951:Table 2

Rerun this analysis yourself

Remove treatments or trials and refit the frequentist and Bayesian models in your browser, with the same methods as the published analysis.

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