Evidence synthesis · §4
Gastrointestinal adverse events with incretin receptor agonists — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
§4Summary of findings
§4.1Summary of findings
Table 7. Summary of findings for Gastrointestinal adverse events with incretin receptor agonists.
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Percentage change in body weight from baselineThe outcome the Institute designates as anchor for this indication. | 42,582 (24) | High certainty evidence indicates that nausea, vomiting, diarrhoea and constipation are substantially more frequent with incretin receptor agonists… | High | no downgrade |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 38,020 (22) | Reported per contributing trial; see the included-studies table | High | no downgrade |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 36,594 (22) | Reported per contributing trial; see the included-studies table | Moderate | indirectness |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 33,847 (23) | Reported per contributing trial; see the included-studies table | Moderate | imprecision |
| Proportion achieving ≥5 %, ≥10 %, ≥15 % and ≥20 % weight reductionA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 19,214 (23) | Reported as a secondary outcome in a subset of contributing trials | Moderate | publication bias |
| Change in waist circumferenceA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 21,121 (23) | Reported as a secondary outcome in a subset of contributing trials | Moderate | publication bias |
| Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes. | ||||
§4.2Forest plot
Study estimatePooled estimate
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | No concern | No serious concern identified in this domain. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | No concern | No serious concern identified in this domain. |
| Imprecision | No concern | No serious concern identified in this domain. |
| Publication bias | No concern | No serious concern identified in this domain. |
| Overall: High certainty. The Institute is confident that the true effect lies close to the estimate. Further research is very unlikely to change confidence in the estimate. | ||
References cited on this page
References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.
- Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine 2021;384(11):989–1002. doi:10.1056/NEJMoa2032183 · PMID 33567185
- Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine 2022;387(3):205–216. doi:10.1056/NEJMoa2206038 · PMID 35658024
Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.
Compound Evidence Institute · CEI-ES-005/4 · https://compoundevidence.com/syntheses/gastrointestinal-tolerability-incretins/summary-of-findings/ · retrieved 30 July 2026