LivingGLP1
Network meta-analysis

Constipation

Overweight or obesity without diabetes (adults)

longest follow-upRecorded harmsDoses of a drug pooledHazard ratio (from event counts)
44
Randomized trials
26
Treatments
19,747
Participants
3,535
Events

In plain language

Across 44 trials with 19,747 participants, 1 of 25 treatments had a clearly better result than placebo on constipation, 8 a clearly worse one, and for 16 the evidence could not tell them apart from placebo. The most favorable estimate was for Ct388 sc: hazard ratio (from event counts) 0.20 (95% credible interval 0.02 to 1.88).

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.
ALENIG_POBIMASEMA_SCCT388_SCDANU_PODAPIGL_SCEFPE_SCEXENER_SCEXEN_SCHRS7535_POLIFESTYLELIRA_SCLOTI_POMARI_SCMAZD_SCORFO_POORLISTATOTHER_ACTIVE_bimagrumabOTHER_ACTIVE_cagrilintidePLACEBORETA_SCSEMA_POSEMA_SCSTANDARD_CARETERN60_POTIRZ_SCVK2735_SC
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 Placebo

Hazard ratio (from event counts). Lower values favor the treatment.
0.010.020.050.10.20.250.51245102050100← favors treatmentfavors reference →Ct388 scStandard care or no added treatm…BimagrumabExenatide injectionLifestyle intervention (randomiz…OrlistatDanuglipron tabletCagrilintideSemaglutide tabletExenatide extended release injec…Mazdutide injectionEfpe scVk2735 scAlenig poBimasema scLiraglutide injectionSemaglutide injectionDapigl scTirzepatide injectionOrforglipron tabletTern60 poRetatrutide injectionMari scLoti poHRS-7535 tablet
Versus Placebo, log scale. 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 Placebo
TreatmentBayesian HR (95% CrI)95% prediction intervalFrequentist HR (95% CI)Verdict
Ct388 sc
CT388_SC
0.20 (0.02 to 1.88)0.02 to 2.02Unclear
Standard care or no added treatment
STANDARD_CARE
0.23 (0.09 to 0.51)0.08 to 0.63Better
Bimagrumab
OTHER_ACTIVE_bimagrumab
0.53 (0.12 to 1.83)0.11 to 2.07Unclear
Exenatide injection
EXEN_SC
0.56 (0.01 to 48.36)0.01 to 51.51Unclear
Lifestyle intervention (randomized arm)
LIFESTYLE
0.61 (0.01 to 41.21)0.01 to 41.88Unclear
Orlistat
ORLISTAT
0.86 (0.31 to 2.14)0.26 to 2.50Unclear
Danuglipron tablet
DANU_PO
1.32 (0.34 to 7.94)0.30 to 8.97Unclear
Cagrilintide
OTHER_ACTIVE_cagrilintide
1.40 (0.73 to 2.85)0.60 to 3.54Unclear
Semaglutide tablet
SEMA_PO
1.81 (0.98 to 3.20)0.77 to 4.07Unclear
Exenatide extended release injection
EXENER_SC
1.81 (0.18 to 22.39)0.18 to 23.83Unclear
Mazdutide injection
MAZD_SC
2.13 (0.37 to 24.27)0.34 to 26.03Unclear
Efpe sc
EFPE_SC
2.30 (0.81 to 7.42)0.72 to 8.39Unclear
Vk2735 sc
VK2735_SC
2.48 (0.85 to 8.94)0.74 to 10.23Unclear
Alenig po
ALENIG_PO
2.57 (1.06 to 6.88)0.91 to 8.12Worse
Bimasema sc
BIMASEMA_SC
2.58 (1.22 to 5.71)1.02 to 6.96Worse
Liraglutide injection
LIRA_SC
2.60 (1.95 to 3.54)1.38 to 5.15Worse
Semaglutide injection
SEMA_SC
2.91 (2.31 to 3.85)1.59 to 5.84Worse
Dapigl sc
DAPIGL_SC
3.08 (0.77 to 17.91)0.71 to 19.44Unclear
Tirzepatide injection
TIRZ_SC
3.09 (2.19 to 4.48)1.59 to 6.39Worse
Orforglipron tablet
ORFO_PO
3.23 (1.94 to 5.62)1.53 to 7.21Worse
Tern60 po
TERN60_PO
3.82 (0.80 to 33.54)0.71 to 35.81Unclear
Retatrutide injection
RETA_SC
3.83 (1.07 to 21.46)0.96 to 24.02Worse
Mari sc
MARI_SC
3.98 (0.30 to 123)0.28 to 134Unclear
Loti po
LOTI_PO
4.42 (1.93 to 10.58)1.61 to 13.04Worse
HRS-7535 tablet
HRS7535_PO
4.45 (0.42 to 115)0.40 to 123Unclear

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.

League table

Every treatment against every other: hazard ratio (from event counts) of the row treatment versus the column treatment, posterior median and 95% credible interval. Green: row clearly better; red: row clearly worse.
Every treatment in a row compared with every treatment in a column
Row versus columnPLACEBOCT388_SCSTANDARD_CAREOTHER_ACTIVE_bimagrumabEXEN_SCLIFESTYLEORLISTATDANU_POOTHER_ACTIVE_cagrilintideSEMA_POEXENER_SCMAZD_SCEFPE_SCVK2735_SCALENIG_POBIMASEMA_SCLIRA_SCSEMA_SCDAPIGL_SCTIRZ_SCORFO_POTERN60_PORETA_SCMARI_SCLOTI_POHRS7535_PO
PLACEBOPLACEBO5.00
0.53 to 61.50
4.29
1.95 to 10.55
1.87
0.55 to 8.13
1.80
0.02 to 170
1.64
0.02 to 166
1.16
0.47 to 3.21
0.76
0.13 to 2.96
0.72
0.35 to 1.37
0.55
0.31 to 1.02
0.55
0.04 to 5.49
0.47
0.04 to 2.69
0.43
0.13 to 1.23
0.40
0.11 to 1.18
0.39
0.15 to 0.95
0.39
0.18 to 0.82
0.38
0.28 to 0.51
0.34
0.26 to 0.43
0.32
0.06 to 1.30
0.32
0.22 to 0.46
0.31
0.18 to 0.52
0.26
0.03 to 1.26
0.26
0.05 to 0.93
0.25
0.01 to 3.30
0.23
0.09 to 0.52
0.22
0.01 to 2.39
CT388_SC0.20
0.02 to 1.88
CT388_SC0.85
0.06 to 9.85
0.38
0.02 to 5.19
0.32
0.00 to 56.19
0.34
0.00 to 55.91
0.23
0.02 to 2.70
0.14
0.01 to 2.13
0.14
0.01 to 1.45
0.11
0.01 to 1.11
0.11
0.00 to 2.67
0.09
0.00 to 1.58
0.09
0.01 to 1.00
0.08
0.00 to 0.92
0.08
0.01 to 0.91
0.08
0.01 to 0.81
0.08
0.01 to 0.72
0.07
0.01 to 0.65
0.06
0.00 to 0.90
0.06
0.01 to 0.59
0.06
0.00 to 0.63
0.05
0.00 to 0.84
0.05
0.00 to 0.66
0.05
0.00 to 1.59
0.04
0.00 to 0.48
0.04
0.00 to 1.26
STANDARD_CARE0.23
0.09 to 0.51
1.17
0.10 to 16.75
STANDARD_CARE0.44
0.09 to 2.32
0.40
0.00 to 41.57
0.39
0.01 to 41.56
0.27
0.08 to 0.95
0.18
0.02 to 0.85
0.17
0.05 to 0.45
0.13
0.04 to 0.35
0.13
0.01 to 1.42
0.11
0.01 to 0.75
0.10
0.03 to 0.36
0.09
0.02 to 0.37
0.09
0.02 to 0.30
0.09
0.03 to 0.26
0.09
0.04 to 0.19
0.08
0.03 to 0.18
0.07
0.01 to 0.38
0.08
0.03 to 0.16
0.07
0.03 to 0.18
0.06
0.01 to 0.35
0.06
0.01 to 0.29
0.06
0.00 to 0.90
0.05
0.02 to 0.17
0.05
0.00 to 0.66
OTHER_ACTIVE_bimagrumab0.53
0.12 to 1.83
2.65
0.19 to 41.82
2.27
0.43 to 10.65
OTHER_ACTIVE_bimagrumab0.93
0.01 to 106
0.86
0.01 to 107
0.62
0.11 to 3.10
0.38
0.04 to 2.45
0.38
0.08 to 1.53
0.29
0.06 to 1.16
0.29
0.02 to 3.91
0.24
0.01 to 2.18
0.23
0.04 to 1.20
0.21
0.03 to 1.14
0.20
0.04 to 0.96
0.21
0.05 to 0.68
0.20
0.05 to 0.71
0.18
0.04 to 0.61
0.17
0.02 to 1.13
0.17
0.04 to 0.61
0.16
0.03 to 0.63
0.13
0.01 to 1.04
0.13
0.02 to 0.82
0.13
0.00 to 2.39
0.12
0.02 to 0.54
0.12
0.00 to 1.79
EXEN_SC0.56
0.01 to 48.36
3.10
0.02 to 431
2.47
0.02 to 229
1.08
0.01 to 109
EXEN_SC1.00
0.00 to 557
0.66
0.01 to 65.25
0.41
0.00 to 45.23
0.40
0.00 to 36.14
0.31
0.00 to 27.20
0.31
0.00 to 45.84
0.26
0.00 to 28.27
0.25
0.00 to 23.40
0.22
0.00 to 23.22
0.21
0.00 to 20.30
0.21
0.00 to 19.91
0.21
0.00 to 20.05
0.19
0.00 to 17.32
0.18
0.00 to 17.16
0.18
0.00 to 16.22
0.17
0.00 to 15.89
0.13
0.00 to 16.61
0.14
0.00 to 14.36
0.13
0.00 to 25.56
0.13
0.00 to 11.81
0.12
0.00 to 18.14
LIFESTYLE0.61
0.01 to 41.21
2.98
0.02 to 365
2.57
0.02 to 181
1.16
0.01 to 90.33
1.00
0.00 to 548
LIFESTYLE0.70
0.01 to 52.06
0.43
0.00 to 37.91
0.43
0.00 to 28.97
0.33
0.00 to 22.74
0.34
0.00 to 42.56
0.26
0.00 to 24.68
0.26
0.00 to 19.58
0.23
0.00 to 18.79
0.23
0.00 to 16.51
0.23
0.00 to 16.48
0.24
0.00 to 15.91
0.21
0.00 to 14.19
0.19
0.00 to 15.86
0.19
0.00 to 13.44
0.19
0.00 to 12.46
0.15
0.00 to 12.65
0.15
0.00 to 11.32
0.14
0.00 to 21.30
0.14
0.00 to 9.33
0.12
0.00 to 16.61
ORLISTAT0.86
0.31 to 2.14
4.40
0.37 to 59.21
3.66
1.06 to 13.10
1.62
0.32 to 8.85
1.51
0.02 to 153
1.43
0.02 to 159
ORLISTAT0.64
0.09 to 3.54
0.62
0.18 to 1.82
0.48
0.15 to 1.40
0.46
0.03 to 5.61
0.39
0.03 to 3.05
0.37
0.08 to 1.55
0.34
0.07 to 1.47
0.33
0.08 to 1.18
0.33
0.09 to 1.11
0.33
0.12 to 0.80
0.30
0.10 to 0.74
0.27
0.04 to 1.48
0.28
0.09 to 0.72
0.27
0.08 to 0.74
0.22
0.02 to 1.39
0.22
0.03 to 1.08
0.21
0.01 to 3.29
0.19
0.05 to 0.66
0.19
0.01 to 2.51
DANU_PO1.32
0.34 to 7.94
6.98
0.47 to 149
5.71
1.18 to 41.38
2.63
0.41 to 23.04
2.43
0.02 to 332
2.31
0.03 to 286
1.55
0.28 to 11.72
DANU_PO0.95
0.20 to 6.38
0.74
0.17 to 4.76
0.77
0.04 to 12.51
0.62
0.04 to 7.34
0.58
0.10 to 4.41
0.53
0.08 to 4.24
0.52
0.10 to 3.70
0.52
0.11 to 3.24
0.51
0.13 to 3.12
0.46
0.11 to 2.74
0.43
0.05 to 4.02
0.43
0.10 to 2.59
0.41
0.09 to 2.70
0.35
0.03 to 3.67
0.34
0.04 to 3.01
0.34
0.01 to 6.63
0.30
0.06 to 2.11
0.30
0.01 to 5.77
OTHER_ACTIVE_cagrilintide1.40
0.73 to 2.85
7.20
0.69 to 94.81
5.99
2.21 to 18.57
2.61
0.65 to 12.69
2.51
0.03 to 251
2.35
0.03 to 253
1.62
0.55 to 5.60
1.05
0.16 to 5.00
OTHER_ACTIVE_cagrilintide0.77
0.33 to 2.01
0.77
0.06 to 8.46
0.65
0.05 to 4.47
0.61
0.16 to 2.18
0.56
0.14 to 2.05
0.54
0.17 to 1.66
0.53
0.20 to 1.51
0.54
0.28 to 1.07
0.48
0.24 to 0.98
0.46
0.07 to 2.24
0.45
0.22 to 0.98
0.43
0.18 to 1.08
0.37
0.04 to 2.05
0.36
0.06 to 1.65
0.36
0.01 to 5.12
0.31
0.11 to 0.96
0.32
0.01 to 3.78
SEMA_PO1.81
0.98 to 3.20
9.18
0.90 to 116
7.72
2.86 to 22.31
3.40
0.86 to 16.36
3.23
0.04 to 315
3.01
0.04 to 318
2.10
0.71 to 6.68
1.35
0.21 to 5.97
1.30
0.50 to 3.05
SEMA_PO0.99
0.08 to 10.33
0.84
0.07 to 5.17
0.78
0.22 to 2.55
0.73
0.18 to 2.41
0.70
0.22 to 1.99
0.70
0.25 to 1.76
0.70
0.34 to 1.30
0.62
0.31 to 1.13
0.59
0.09 to 2.61
0.59
0.29 to 1.11
0.56
0.25 to 1.17
0.47
0.05 to 2.49
0.46
0.08 to 1.85
0.45
0.01 to 6.23
0.41
0.16 to 0.94
0.41
0.01 to 4.60
EXENER_SC1.81
0.18 to 22.39
9.36
0.37 to 324
7.67
0.70 to 110
3.41
0.26 to 60.44
3.26
0.02 to 506
2.97
0.02 to 552
2.17
0.18 to 31.34
1.31
0.08 to 23.23
1.29
0.12 to 17.42
1.01
0.10 to 12.92
EXENER_SC0.82
0.03 to 19.06
0.78
0.06 to 11.59
0.71
0.05 to 11.00
0.70
0.06 to 10.07
0.70
0.06 to 9.25
0.69
0.07 to 8.40
0.62
0.06 to 7.54
0.57
0.03 to 9.97
0.58
0.06 to 7.11
0.56
0.05 to 7.04
0.45
0.02 to 9.95
0.46
0.03 to 7.75
0.45
0.01 to 16.27
0.40
0.03 to 5.54
0.40
0.01 to 12.17
MAZD_SC2.13
0.37 to 24.27
10.93
0.63 to 335
9.29
1.34 to 116
4.16
0.46 to 69.07
3.87
0.04 to 593
3.79
0.04 to 572
2.53
0.33 to 33.21
1.61
0.14 to 24.39
1.54
0.22 to 18.57
1.18
0.19 to 14.10
1.21
0.05 to 32.56
MAZD_SC0.95
0.11 to 11.52
0.85
0.10 to 11.96
0.83
0.12 to 10.22
0.83
0.12 to 10.25
0.82
0.14 to 9.27
0.73
0.12 to 8.56
0.68
0.06 to 10.82
0.69
0.12 to 7.99
0.66
0.10 to 7.60
0.55
0.03 to 9.83
0.54
0.05 to 8.56
0.54
0.01 to 16.67
0.48
0.07 to 6.10
0.48
0.01 to 14.46
EFPE_SC2.30
0.81 to 7.42
11.59
1.00 to 183
9.93
2.76 to 39.94
4.43
0.84 to 26.98
4.07
0.04 to 419
3.88
0.05 to 432
2.71
0.65 to 12.34
1.74
0.23 to 10.33
1.64
0.46 to 6.18
1.27
0.39 to 4.61
1.29
0.09 to 16.07
1.06
0.09 to 8.85
EFPE_SC0.93
0.18 to 4.44
0.90
0.22 to 3.72
0.90
0.24 to 3.41
0.88
0.30 to 2.90
0.79
0.27 to 2.53
0.74
0.10 to 4.72
0.74
0.25 to 2.51
0.71
0.21 to 2.54
0.59
0.06 to 4.50
0.59
0.08 to 3.33
0.60
0.02 to 9.78
0.52
0.13 to 2.16
0.52
0.02 to 7.37
VK2735_SC2.48
0.85 to 8.94
12.94
1.08 to 201
10.89
2.72 to 50.01
4.77
0.88 to 31.21
4.46
0.04 to 479
4.37
0.05 to 484
2.94
0.68 to 14.76
1.89
0.24 to 11.87
1.79
0.49 to 7.39
1.38
0.41 to 5.59
1.40
0.09 to 18.30
1.18
0.08 to 10.13
1.08
0.23 to 5.62
VK2735_SC0.97
0.22 to 4.56
0.97
0.25 to 4.22
0.96
0.31 to 3.52
0.85
0.28 to 3.06
0.81
0.10 to 5.36
0.80
0.25 to 3.02
0.77
0.23 to 2.98
0.64
0.06 to 4.97
0.64
0.09 to 3.88
0.64
0.02 to 10.56
0.57
0.14 to 2.52
0.57
0.02 to 8.62
ALENIG_PO2.57
1.06 to 6.88
13.19
1.09 to 187
11.10
3.33 to 40.80
4.89
1.04 to 27.68
4.68
0.05 to 484
4.27
0.06 to 491
3.01
0.84 to 12.07
1.94
0.27 to 10.40
1.84
0.60 to 5.73
1.43
0.50 to 4.53
1.44
0.10 to 16.53
1.20
0.10 to 8.49
1.12
0.27 to 4.56
1.03
0.22 to 4.51
ALENIG_PO1.00
0.30 to 3.32
0.99
0.38 to 2.65
0.88
0.35 to 2.40
0.82
0.13 to 4.50
0.84
0.32 to 2.31
0.80
0.28 to 2.34
0.67
0.06 to 4.20
0.66
0.10 to 3.29
0.65
0.02 to 9.86
0.58
0.17 to 2.07
0.58
0.02 to 7.29
BIMASEMA_SC2.58
1.22 to 5.71
13.22
1.23 to 166
11.11
3.80 to 36.36
4.84
1.48 to 20.69
4.67
0.05 to 438
4.30
0.06 to 479
3.02
0.90 to 10.94
1.92
0.31 to 9.28
1.87
0.66 to 4.92
1.42
0.57 to 3.93
1.43
0.11 to 16.08
1.21
0.10 to 8.13
1.11
0.29 to 4.16
1.03
0.24 to 4.06
1.00
0.30 to 3.32
BIMASEMA_SC0.99
0.45 to 2.22
0.89
0.43 to 1.82
0.84
0.13 to 4.15
0.83
0.37 to 1.90
0.80
0.31 to 2.05
0.67
0.07 to 3.90
0.67
0.10 to 2.94
0.64
0.02 to 9.16
0.58
0.19 to 1.84
0.59
0.02 to 7.23
LIRA_SC2.60
1.95 to 3.54
13.27
1.39 to 163
11.11
5.14 to 28.24
4.89
1.40 to 21.74
4.65
0.05 to 437
4.25
0.06 to 434
3.01
1.25 to 8.42
1.98
0.32 to 7.92
1.86
0.93 to 3.52
1.44
0.77 to 2.90
1.45
0.12 to 14.57
1.22
0.11 to 7.36
1.14
0.34 to 3.33
1.05
0.28 to 3.26
1.01
0.38 to 2.60
1.01
0.45 to 2.22
LIRA_SC0.89
0.63 to 1.25
0.85
0.14 to 3.50
0.84
0.54 to 1.30
0.80
0.44 to 1.47
0.68
0.08 to 3.46
0.68
0.12 to 2.54
0.65
0.02 to 8.83
0.59
0.24 to 1.46
0.59
0.02 to 6.42
SEMA_SC2.91
2.31 to 3.85
14.73
1.55 to 182
12.48
5.65 to 31.85
5.47
1.65 to 23.45
5.20
0.06 to 498
4.81
0.07 to 479
3.39
1.34 to 9.54
2.20
0.36 to 8.82
2.08
1.02 to 4.17
1.60
0.89 to 3.18
1.61
0.13 to 16.00
1.37
0.12 to 8.15
1.26
0.39 to 3.71
1.18
0.33 to 3.63
1.14
0.42 to 2.88
1.13
0.55 to 2.31
1.12
0.80 to 1.59
SEMA_SC0.95
0.16 to 3.91
0.94
0.65 to 1.39
0.90
0.50 to 1.63
0.76
0.09 to 3.74
0.75
0.13 to 2.80
0.73
0.02 to 9.72
0.66
0.27 to 1.60
0.66
0.03 to 7.03
DAPIGL_SC3.08
0.77 to 17.91
16.08
1.11 to 323
13.43
2.62 to 89.81
6.01
0.89 to 55.94
5.64
0.06 to 740
5.39
0.06 to 686
3.71
0.68 to 26.51
2.34
0.25 to 20.74
2.17
0.45 to 13.91
1.70
0.38 to 11.22
1.76
0.10 to 29.85
1.47
0.09 to 17.63
1.34
0.21 to 10.34
1.24
0.19 to 9.68
1.22
0.22 to 7.91
1.19
0.24 to 7.87
1.17
0.29 to 6.96
1.05
0.26 to 6.11
DAPIGL_SC0.99
0.24 to 5.62
0.96
0.22 to 5.72
0.81
0.06 to 8.34
0.80
0.09 to 7.02
0.78
0.02 to 17.46
0.70
0.14 to 4.71
0.72
0.02 to 14.12
TIRZ_SC3.09
2.19 to 4.48
15.58
1.69 to 199
13.14
6.10 to 32.76
5.84
1.65 to 25.87
5.64
0.06 to 527
5.17
0.07 to 503
3.61
1.38 to 10.72
2.35
0.39 to 9.74
2.22
1.02 to 4.62
1.71
0.90 to 3.50
1.74
0.14 to 17.48
1.46
0.13 to 8.69
1.35
0.40 to 4.08
1.25
0.33 to 3.97
1.19
0.43 to 3.15
1.20
0.53 to 2.70
1.19
0.77 to 1.84
1.06
0.72 to 1.54
1.01
0.18 to 4.23
TIRZ_SC0.96
0.51 to 1.80
0.81
0.09 to 3.97
0.80
0.14 to 3.04
0.78
0.02 to 9.99
0.70
0.28 to 1.77
0.70
0.03 to 7.83
ORFO_PO3.23
1.94 to 5.62
16.48
1.59 to 217
13.87
5.51 to 39.11
6.08
1.58 to 29.15
5.84
0.06 to 540
5.29
0.08 to 567
3.75
1.35 to 11.91
2.46
0.37 to 10.75
2.33
0.92 to 5.42
1.78
0.85 to 4.07
1.80
0.14 to 19.04
1.50
0.13 to 9.71
1.41
0.39 to 4.69
1.30
0.34 to 4.39
1.25
0.43 to 3.63
1.25
0.49 to 3.23
1.24
0.68 to 2.27
1.12
0.61 to 1.98
1.05
0.17 to 4.62
1.04
0.55 to 1.96
ORFO_PO0.84
0.09 to 4.43
0.84
0.14 to 3.42
0.82
0.02 to 11.50
0.73
0.27 to 1.99
0.74
0.03 to 8.35
TERN60_PO3.82
0.80 to 33.54
20.75
1.20 to 549
17.11
2.84 to 167
7.65
0.96 to 94.57
7.54
0.06 to 939
6.85
0.08 to 1126
4.53
0.72 to 48.94
2.90
0.27 to 37.78
2.73
0.49 to 26.51
2.14
0.40 to 20.60
2.22
0.10 to 49.94
1.83
0.10 to 30.95
1.69
0.22 to 18.11
1.55
0.20 to 16.94
1.49
0.24 to 15.54
1.49
0.26 to 14.65
1.47
0.29 to 13.05
1.31
0.27 to 11.50
1.24
0.12 to 17.54
1.24
0.25 to 11.27
1.19
0.23 to 11.10
TERN60_PO1.00
0.10 to 12.71
1.02
0.02 to 27.37
0.87
0.14 to 8.93
0.89
0.02 to 21.57
RETA_SC3.83
1.07 to 21.46
20.25
1.53 to 407
16.93
3.43 to 110
7.52
1.22 to 62.29
7.15
0.07 to 894
6.87
0.09 to 859
4.58
0.93 to 32.60
2.93
0.33 to 25.07
2.76
0.60 to 17.28
2.15
0.54 to 12.85
2.20
0.13 to 35.55
1.85
0.12 to 21.76
1.68
0.30 to 11.77
1.57
0.26 to 10.89
1.50
0.30 to 10.24
1.49
0.34 to 9.55
1.48
0.39 to 8.34
1.33
0.36 to 7.53
1.26
0.14 to 11.03
1.25
0.33 to 7.02
1.20
0.29 to 6.98
1.00
0.08 to 9.94
RETA_SC1.00
0.03 to 21.67
0.88
0.19 to 5.70
0.89
0.03 to 15.71
MARI_SC3.98
0.30 to 123
21.36
0.63 to 1309
17.46
1.11 to 627
7.61
0.42 to 322
7.48
0.04 to 1836
7.12
0.05 to 2061
4.81
0.30 to 161
2.94
0.15 to 119
2.80
0.20 to 91.07
2.21
0.16 to 70.49
2.25
0.06 to 130
1.84
0.06 to 86.66
1.67
0.10 to 62.08
1.57
0.09 to 57.61
1.53
0.10 to 53.64
1.57
0.11 to 53.99
1.54
0.11 to 49.21
1.36
0.10 to 43.72
1.29
0.06 to 56.88
1.29
0.10 to 41.24
1.22
0.09 to 40.51
0.98
0.04 to 45.27
1.00
0.05 to 39.78
MARI_SC0.91
0.06 to 31.01
0.89
0.01 to 59.78
LOTI_PO4.42
1.93 to 10.58
22.68
2.08 to 299
18.98
6.01 to 65.41
8.40
1.87 to 46.87
7.79
0.08 to 824
7.40
0.11 to 753
5.20
1.51 to 19.53
3.34
0.47 to 16.49
3.20
1.04 to 9.19
2.44
1.06 to 6.08
2.49
0.18 to 28.67
2.08
0.16 to 15.01
1.92
0.46 to 7.47
1.77
0.40 to 7.10
1.72
0.48 to 5.81
1.71
0.54 to 5.34
1.70
0.69 to 4.18
1.52
0.62 to 3.68
1.43
0.21 to 7.07
1.43
0.56 to 3.57
1.37
0.50 to 3.69
1.15
0.11 to 7.10
1.14
0.18 to 5.30
1.10
0.03 to 16.83
LOTI_PO1.01
0.03 to 12.14
HRS7535_PO4.45
0.42 to 115
23.55
0.79 to 1354
18.95
1.52 to 568
8.68
0.56 to 308
8.60
0.06 to 1927
8.28
0.06 to 1805
5.16
0.40 to 166
3.31
0.17 to 113
3.14
0.26 to 88.37
2.47
0.22 to 68.74
2.52
0.08 to 124
2.06
0.07 to 88.03
1.92
0.14 to 59.02
1.76
0.12 to 54.17
1.73
0.14 to 51.87
1.71
0.14 to 47.28
1.70
0.16 to 45.32
1.52
0.14 to 39.14
1.39
0.07 to 49.61
1.42
0.13 to 37.04
1.35
0.12 to 38.16
1.12
0.05 to 41.84
1.13
0.06 to 39.11
1.12
0.02 to 76.55
0.99
0.08 to 29.69
HRS7535_PO

Heterogeneity, fit and convergence

Bayesian random effects (primary)

Heterogeneity (tau)
0.264 (95% CrI 0.106 to 0.499), log scale
Residual deviance
101.7 for 95 data points
DIC
172.4 (pD 70.7)
Largest R-hat
1.001
Smallest ESS
bulk 1,564, tail 2,643
Divergent transitions
0
Convergence
All criteria met
Priors
PR02 N(0, 5^2); PR05 N(0, 2.5^2); PR09 log normal(-1.87, 1.52^2) on tau^2 (Adverse events, pharm vs placebo control)

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.

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.
  • NoteOutcome assessment, time point: selected time points span 4.29 to 193 weeks
  • NoteOutcome assessment, analysis set: mixed: randomized 10, safety 34
  • NoteOutcome assessment, definition: mixed: deaths in safety population 1, nausea 1, not stated 41, participants with serious treatment emergent adverse events 1
  • NoteOutcome assessment, intercurrent events (discontinuation): mixed: not stated 43, while_on_treatment 1
  • NoteOutcome assessment, intercurrent events (rescue): mixed: not stated 43, treatment_policy 1
  • NoteRisk of bias, blinding: mixed: double_blind 39, open_label 4, single_blind 1
  • NoteRisk of bias, funding: mixed: industry 39, mixed 2, non_industry 2, not_reported 1
  • NoteData handling, input conversions: arms_combined 23, nonserious_only 38, printed_denominator 8
Comparability items per trial
Trialanalysis settime weeksdefinitionadjudicatedinstrumentproportion methodintercurrent events (discontinuation)intercurrent events (rescue)blindingfundingstart yearEligibility
STEP 10safety57not statednot statednot statednot statednot statednot stateddouble_blindindustry2021Adults with obesity and prediabetes; diabetes excluded
TOGETHER-PsOsafety36not statednot statednot statednot statednot statednot statedopen_labelindustry2024adults; moderate to severe plaque psoriasis; PASI 12 or more; BMI 30 or more, or 27 to 30 with comorbidity
NCT04081337randomized22not statednot statednot statednot statednot statednot stateddouble_blindindustry2020age 18 to 60; BMI 30 to 45; no diabetes; at least one metabolic impairment
SURMOUNT-5safety72not statednot statednot statednot statednot statednot statedopen_labelindustry2023adults; BMI 30 or more, or 27 with complication; no diabetes
STEP 1safety75not statednot statednot statednot statedwhile_on_treatmenttreatment_policydouble_blindindustry2018adults; BMI 30 or more, or 27 or more with a weight related condition; no diabetes; HbA1c below 6.5 percent
STEP 5safety111not statednot statednot statednot statednot statednot stateddouble_blindindustry2018age 18 or older; BMI 30 or more, or 27 or more with comorbidity; no diabetes; HbA1c below 6.5 percent
NCT04707313safety37not statednot statednot statednot statednot statednot stateddouble_blindindustry2021age 18 to 75; BMI 30 or higher; no diabetes; stable weight
NCT04311411safety10nauseanot statednot statednot statednot statednot stateddouble_blindindustry2020adults 18 to 65, BMI 27 to 50, no diabetes, HbA1c below 6.5
NCT03041792safety10.43not statednot statednot statednot statednot statednot stateddouble_blindindustry2017age 18 to 75; BMI 30 to 40; no diabetes; HbA1c below 6.5 percent
BARI-STEPrandomized74not statednot statednot statednot statednot statednot stateddouble_blindmixed2022age 18 to 65; at least 1 year after primary bypass or sleeve; less than 20 percent weight loss from surgery
NCT05579977safety28not statednot statednot statednot statednot statednot stateddouble_blindindustry2022age 18 to 75; T2D cohort on metformin, HbA1c 7.0 to 10.0, BMI 23 or more; obesity cohort BMI 30 or more without diabetes
BARIOPTIMISErandomized28not statednot statednot statednot statednot statednot stateddouble_blindmixed2018adults at least 1 year after RYGB or sleeve gastrectomy with 20 percent or less weight loss and suboptimal GLP-1 response
VENTUREsafety19not statednot statednot statednot statednot statednot stateddouble_blindindustry2023age over 18; BMI 30 or more, or 27 or more with comorbidity; BMI 50 or less; no diabetes
NCT05616013safety104not statednot statednot statednot statednot statednot statedopen_labelindustry2022adults 18 to 80; BMI 30 or more, or 27 or more with comorbidity; no diabetes (HbA1c below 6.5 percent); weight below 150 kg
NCT02075281safety26not statednot statednot statednot statednot statednot stateddouble_blindindustry2014age 18 to 64 years; BMI 30 to 42, or 27 to 30 with comorbidity; FPG below 7 mmol/L; HbA1c 6.5 percent or less; no diabetes
NCT02160990randomized4.29not statednot statednot statednot statednot statednot stateddouble_blindnon_industry2014Adults; BMI 30 to 40; accelerated gastric emptying; no diabetes
ACCESSsafety36not statednot statednot statednot statednot statednot stateddouble_blindindustry2024age 18 to 79; BMI 30 or more, or 27 or more with comorbidity; HbA1c below 6.5 percent; weight above 80 kg; no diabetes
STEP 3safety75not statednot statednot statednot statednot statednot stateddouble_blindindustry2018BMI 30 or more, or 27 with comorbidity; no type 2 diabetes
NCT02647944randomized16not statednot statednot statednot statednot statednot stateddouble_blindnot_reported2015adults with obesity
SURMOUNT-1safety193not statednot statednot statednot statednot statednot stateddouble_blindindustry2019age 18 or older; BMI 30 or more, or 27 or more with a weight related complication; no diabetes
NCT04478708safety29.43not statednot statednot statednot statednot statednot stateddouble_blindindustry2020age 18 to 65; BMI 30 to 40; HbA1c at most 6.5 or fasting glucose below 125 mg/dL
Dapalostsafety24not statednot statednot statednot statednot statednot stateddouble_blindindustry2014age 18 to 70; BMI 30 to 45 kg/m2; no diabetes
NCT00781937safety57not statednot statednot statednot statednot statednot stateddouble_blindindustry2008BMI 30 or more or 27 with comorbidity; no diabetes; at least 5 percent loss on run in
STEP7safety51not statednot statednot statednot statednot statednot stateddouble_blindindustry2020age 18 or older; BMI 30 or more, or 27 or more with a weight related comorbidity including T2D
STABLE Wt Lossrandomized60not statednot statednot statednot statednot statednot stateddouble_blindindustry2022age 18 to 70; BMI 30 or more, or 27 or more with comorbidity; no diabetes; HbA1c 6.5 percent or less
OASIS 1safety75not statednot statednot statednot statednot statednot stateddouble_blindindustry2021overweight or obesity
NCT03856047safety26not statednot statednot statednot statednot statednot stateddouble_blindindustry2019age 18 or older; BMI 30 or more, or 27 or more with hypertension or dyslipidemia; no diabetes
NCT05623839safety27not statednot statednot statednot statednot statednot stateddouble_blindindustry2022age 18 to 70; BMI 27 to 50; HbA1c below 6.5 percent; no diabetes
STEP 8safety75not statednot statednot statednot statednot statednot stateddouble_blindindustry2019age 18 or older; BMI 30 or higher, or 27 with a weight related comorbidity; no type 2 diabetes
NCT04881760safety52not statednot statednot statednot statednot statednot stateddouble_blindindustry202118 to 75 years; BMI 30 or more, or 27 to less than 30 with weight related complication; no type 2 diabetes
STRIVEsafety104not statednot statednot statednot statednot statednot statedopen_labelindustry2017age 18 to 75; BMI 35 or more plus prediabetes, T2D, hypertension or sleep apnea; no insulin or GLP-1 RA
ATTAIN-1safety74deaths in safety populationnot statednot statednot statednot statednot stateddouble_blindindustry2023adults BMI 30 or more, or 27 or more with a weight related complication, without diabetes
TOGETHER-PsAsafety36not statednot statednot statednot statednot statednot statedsingle_blindindustry2024age 18 to 80; active psoriatic arthritis; BMI 30 or more, or 27 to 30 with a weight related comorbidity
DREAMrandomized16not statednot statednot statednot statednot statednot stateddouble_blindindustry2023age 18 to 75; BMI 30 or more; no diabetes, HbA1c below 48 mmol/mol
STEP 6safety75not statednot statednot statednot statednot statednot stateddouble_blindindustry2019
SURMOUNT-3safety76not statednot statednot statednot statednot statednot stateddouble_blindindustry2021age 18 or older; BMI 30 or more, or 27 or more with comorbidity; no diabetes; at least 5 percent loss in lead in
NCT06250946safety36not statednot statednot statednot statednot statednot stateddouble_blindindustry2024age 18 to 65; BMI 28 to 40; no diabetes, HbA1c below 6.5 percent
NCT01557166safety34participants with serious treatment emergent adverse eventsnot statednot statednot statednot statednot stateddouble_blindindustry2012age 18 to 64; BMI 30 or more; AHI 15 or more; no diabetes; unable or unwilling to use CPAP
NCT02453711safety59not statednot statednot statednot statednot statednot stateddouble_blindindustry2015BMI 30 or more without diabetes
NCT05051579safety38not statednot statednot statednot statednot statednot stateddouble_blindindustry2021adults BMI 30 or more, or 27 to 30 with a weight related complication, without diabetes
FALCONsafety16not statednot statednot statednot statednot statednot stateddouble_blindindustry2025age 18 to 75; BMI 27 to below 50 with comorbidity if below 30; HbA1c below 6.5
NCT04838405randomized24not statednot statednot statednot statednot statednot stateddouble_blindindustry2021age 18 to 65, BMI 25 or more (30 or more in cohorts 7 and 8), no diabetes
S002970randomized26.07not statednot statednot statednot statednot statednot stateddouble_blindnon_industry2019age 20 to 75; BMI 27 to 40; impaired glucose tolerance by OGTT; no diabetes
S003067randomized52not statednot statednot statednot statednot statednot stateddouble_blindindustry2007age 18 to 65; BMI 30 to 40; FPG below 7 mmol/L; no diabetes

Trial data

What each trial contributes. Arm rows give the arm value with its standard error, or events over participants; contrast rows give the hazard ratio (from event counts) on the analysis scale (log) against the trial's first row. Flags mark converted, combined or approximated inputs.
Trial data entering this analysis
TrialArmTreatmentWeekDataValueSEEvents / NFlagsSource
TOGETHER-PsOA1STANDARD_CARE36arm, events0 / 134printed_denominatorR0014237:Table 3
TOGETHER-PsOA2TIRZ_SC36arm, events18 / 138printed_denominatorR0014237:Table 3
NCT04081337A1PLACEBO22arm, events4 / 28R0004227:Supplement Table S1
NCT04081337A2TIRZ_SC22arm, events10 / 27R0004227:Supplement Table S1
SURMOUNT-5A1TIRZ_SC72arm, events101 / 375nonserious_onlyregistry:adverse_events
SURMOUNT-5A2SEMA_SC72arm, events107 / 376nonserious_onlyregistry:adverse_events
STEP 1A1SEMA_SC75arm, events306 / 1,306R0023399:Table 3
STEP 1A2PLACEBO75arm, events62 / 655R0023399:Table 3
STEP 5A1SEMA_SC111arm, events47 / 152R0021896:Table 3
STEP 5A2PLACEBO111arm, events17 / 152R0021896:Table 3
NCT04707313A11+A12+A13DANU_PO37arm, events14 / 110arms_combinedR0005921:Table 2
NCT04707313A2PLACEBO37arm, events2 / 19R0005921:Table 2
NCT04311411A1PLACEBO10arm, events0 / 39nonserious_onlyregistry:adverse_events
NCT04311411A2LIRA_SC10arm, events5 / 38nonserious_onlyregistry:adverse_events
NCT04311411A3TIRZ_SC10arm, events7 / 37nonserious_onlyregistry:adverse_events
NCT03041792A1LIRA_SC10.43arm, events9 / 32R0023522:Table 2
NCT03041792A2PLACEBO10.43arm, events3 / 29R0023522:Table 2
BARI-STEPA1PLACEBO74arm, events8 / 35R0014003:Table 3
BARI-STEPA2SEMA_SC74arm, events13 / 35R0014003:Table 3
NCT05579977A1+A8PLACEBO28arm, events6 / 139arms_combinedR0004106:Table 2
NCT05579977A10+A11+A12+A13+A2+A3+A4+A5+A6+A9LOTI_PO28arm, events106 / 690arms_combinedR0004106:Table 2
NCT05579977A7SEMA_PO28arm, events4 / 73R0004106:Table 2
BARIOPTIMISEA1PLACEBO28arm, events2 / 35R0017334:Table 3
BARIOPTIMISEA2LIRA_SC28arm, events9 / 35R0017334:Table 3
VENTUREA1PLACEBO19arm, events4 / 35R0011224:Table 3
VENTUREA2+A3+A4+A5VK2735_SC19arm, events36 / 141arms_combinedR0011224:Table 3
NCT05616013A3OTHER_ACTIVE_bimagrumab104arm, events3 / 57nonserious_onlyregistry:adverse_events
NCT05616013A4+A5SEMA_SC104arm, events27 / 113nonserious_only;arms_combinedregistry:adverse_events
NCT05616013A6+A7+A8+A9BIMASEMA_SC104arm, events49 / 225nonserious_only;arms_combinedregistry:adverse_events
NCT02075281A1PLACEBO26arm, events5 / 60R0011218:Table 3
NCT02075281A2+A3+A4+A5EFPE_SC26arm, events43 / 237arms_combinedR0011218:Table 3
STEP 10A1SEMA_SC57arm, events25 / 138nonserious_onlyregistry:adverse_events
STEP 10A2PLACEBO57arm, events0 / 69nonserious_onlyregistry:adverse_events
NCT02160990A1PLACEBO4.29arm, events0 / 10R0020690:Results
NCT02160990A2EXEN_SC4.29arm, events0 / 10R0020690:Results
ACCESSA1+A2+A3ALENIG_PO36arm, events57 / 174arms_combinedR0000892:Table 2
ACCESSA4PLACEBO36arm, events8 / 56R0000892:Table 2
STEP 3A1SEMA_SC75arm, events150 / 407nonserious_onlyregistry:adverse_events
STEP 3A2PLACEBO75arm, events50 / 204nonserious_onlyregistry:adverse_events
NCT02647944A1LIRA_SC16arm, events2 / 19nonserious_onlyregistry:adverse_events
NCT02647944A2PLACEBO16arm, events2 / 21nonserious_onlyregistry:adverse_events
SURMOUNT-1A1PLACEBO193arm, events38 / 643nonserious_onlyregistry:adverse_events
SURMOUNT-1A2+A3+A4TIRZ_SC193arm, events310 / 1,896nonserious_only;arms_combinedregistry:adverse_events
NCT04478708A10+A11+A14+A9MARI_SC29.43arm, events3 / 30printed_denominator;nonserious_only;printed_denominator;arms_combinedR0006305:Table 2
NCT04478708A15+A8PLACEBO29.43arm, events0 / 9nonserious_only;printed_denominator;printed_denominator;arms_combinedregistry:adverse_events
DapalostA1EXENER_SC24arm, events2 / 25R0025627:Table 3
DapalostA2PLACEBO24arm, events1 / 25R0025627:Table 3
NCT00781937A1LIRA_SC57arm, events57 / 212nonserious_onlyregistry:adverse_events
NCT00781937A2PLACEBO57arm, events26 / 210nonserious_onlyregistry:adverse_events
STEP7A1SEMA_SC51arm, events29 / 249nonserious_onlyregistry:adverse_events
STEP7A2PLACEBO51arm, events7 / 126nonserious_onlyregistry:adverse_events
STABLE Wt LossA1SEMA_SC60arm, events38 / 72R0013679:Table 4
STABLE Wt LossA2PLACEBO60arm, events8 / 48R0013679:Table 4
OASIS 1A1SEMA_PO75arm, events92 / 334nonserious_onlyregistry:adverse_events
OASIS 1A2PLACEBO75arm, events50 / 333nonserious_onlyregistry:adverse_events
NCT03856047A1+A2+A3+A4+A5OTHER_ACTIVE_cagrilintide26arm, events66 / 506arms_combinedR0017871:Table 3
NCT03856047A6LIRA_SC26arm, events26 / 99R0017871:Table 3
NCT03856047A7PLACEBO26arm, events7 / 101R0017871:Table 3
NCT05623839A1PLACEBO27arm, events1 / 8R0013210:Supplement Table S2
NCT05623839A2+A3MAZD_SC27arm, events6 / 24arms_combinedR0013210:Supplement Table S2
STEP 8A1SEMA_SC75arm, events49 / 126nonserious_onlyregistry:adverse_events
STEP 8A2LIRA_SC75arm, events40 / 127nonserious_onlyregistry:adverse_events
STEP 8A3PLACEBO75arm, events20 / 85nonserious_onlyregistry:adverse_events
NCT04881760A1PLACEBO52arm, events2 / 70nonserious_onlyregistry:adverse_events
NCT04881760A2+A3+A4+A5+A6+A7RETA_SC52arm, events30 / 268nonserious_only;arms_combinedregistry:adverse_events
STRIVEA1STANDARD_CARE104arm, events4 / 132R0020855:Table 4
STRIVEA2LIRA_SC104arm, events84 / 260R0020855:Table 4
ATTAIN-1A1PLACEBO74arm, events88 / 949nonserious_onlyregistry:adverse_events
ATTAIN-1A2+A3+A4ORFO_PO74arm, events557 / 2,178nonserious_only;arms_combinedregistry:adverse_events
TOGETHER-PsAA1STANDARD_CARE36arm, events4 / 132printed_denominatorR0018951:Table 3
TOGETHER-PsAA2TIRZ_SC36arm, events23 / 138printed_denominatorR0018951:Table 3
DREAMA1PLACEBO16arm, events2 / 18R0011013:Table 3
DREAMA2+A3DAPIGL_SC16arm, events11 / 36arms_combinedR0011013:Table 3
STEP 6A1+A2SEMA_SC75arm, events71 / 300nonserious_only;arms_combinedregistry:adverse_events
STEP 6A3PLACEBO75arm, events3 / 101nonserious_onlyregistry:adverse_events
SURMOUNT-3A1TIRZ_SC76arm, events66 / 287R0007405:Table 3
SURMOUNT-3A2PLACEBO76arm, events20 / 292R0007405:Table 3
NCT06250946A1PLACEBO36arm, events0 / 46R0001289:Supplement Table 6
NCT06250946A2+A3+A4+A5HRS7535_PO36arm, events5 / 189arms_combinedR0001289:Supplement Table 6
NCT01557166A1LIRA_SC34arm, events21 / 180R0026203:Table 2
NCT01557166A2PLACEBO34arm, events6 / 179R0026203:Table 2
NCT02453711A1+A2+A3+A4+A5+A6+A7SEMA_SC59arm, events151 / 718nonserious_only;arms_combinedregistry:adverse_events
NCT02453711A8LIRA_SC59arm, events24 / 103nonserious_onlyregistry:adverse_events
NCT02453711A9PLACEBO59arm, events6 / 136nonserious_onlyregistry:adverse_events
NCT05051579A1+A2+A3+A4+A5+A6ORFO_PO38arm, events54 / 222nonserious_only;arms_combinedregistry:adverse_events
NCT05051579A7PLACEBO38arm, events3 / 50nonserious_onlyregistry:adverse_events
FALCONA1PLACEBO16arm, events1 / 33R0004304:Table 2
FALCONA2+A3+A4+A5TERN60_PO16arm, events16 / 134arms_combinedR0004304:Table 2
NCT04838405A1PLACEBO24arm, events2 / 10R0007991:Table 2
NCT04838405A2+A3+A4+A5+A6CT388_SC24arm, events1 / 30arms_combinedR0007991:Table 2
S002970A1LIFESTYLE26.07arm, events0 / 22R0008860:Supplementary Table SI
S002970A2LIRA_SC26.07arm, events0 / 17R0008860:Supplementary Table SI
S003067A1PLACEBO52arm, events12 / 98R0025439:Table 2
S003067A2+A3+A4+A5LIRA_SC52arm, events64 / 371arms_combinedR0025439:Table 2
S003067A6ORLISTAT52arm, events7 / 95R0025439:Table 2

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