Independent · non-commercial · publishes on a quarterly cycle|Current cycle 2026 Q3
Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Evidence synthesis · §3

The rodent thyroid C-cell signal and its human relevance — included and excluded studies

The included-studies table with extracted data, the exclusions with reasons, and the risk-of-bias judgements.

Document identifier
CEI-ES-021/3
Series
Evidence synthesis
Version
1.3
Published
23 Feb 2024
Last reviewed
23 Aug 2024
Next review
23 Feb 2026
Identifier
10.71829/cei.syn.21
Certainty
Low
Cycle
2024 Q1
Review type
Safety review
Search executed
16 Jan 2024

§3Included and excluded studies

Every study contributing to this review is listed below with the data extracted from it. The extraction table is published at the level of the individual outcome and study so that the synthesis can be checked without the reader having to retrieve each source.

§3.1Included studies

Table 4. Included studies with the characteristics extracted from each.

StudyDesignRandomisedDurationAnchor outcome as reportedYear
ESSENCESemaglutideRandomised, double-blind, placebo-controlled1,19772 weeks for part 1Resolution in 62.9 % versus 34.3 % with placebo; difference 28.7 percentage points (95 % CI 21.1 to 36.2)2025
EXENATIDE-GE-PDExenatideRandomised, double-blind, placebo-controlled19496 weeksNo significant difference from placebo. The Institute records this as a negative result of a widely publicised earlier phase 2 signal2025
STRIDESemaglutideRandomised, double-blind, placebo-controlled79252 weeksEstimated treatment ratio 1.13 (95 % CI 1.06 to 1.21)2025
FLOWSemaglutideEvent-driven kidney outcome trial3,533Median 3.4 yearsHazard ratio 0.76 (95 % CI 0.66 to 0.88); annual eGFR slope difference 1.16 mL/min/1.73 m² per year2024
STEP-HFpEF-DMSemaglutideRandomised, double-blind, placebo-controlled61652 weeksDirectionally consistent with STEP-HFpEF with a smaller weight effect, as expected in a population with diabetes2024
SELECTSemaglutideEvent-driven cardiovascular outcome trial17,604Mean 39.8 monthsHazard ratio 0.80 (95 % CI 0.72 to 0.90); 6.5 % versus 8.0 %2023
STEP-HFpEFSemaglutideRandomised, double-blind, placebo-controlled52952 weeksClinical summary score improved 16.6 points versus 8.7 points with placebo; estimated difference 7.8 points (95 % CI 4.8 to 10.9)2023
STEP-5SemaglutideRandomised, double-blind, placebo-controlled304104 weeksMean change −15.2 % versus −2.6 % with placebo; the longest randomised exposure in the programme2022
STEP-8SemaglutideRandomised, double-blind, active-controlled33868 weeksMean change −15.8 % with semaglutide versus −6.4 % with liraglutide; difference −9.4 percentage points (95 % CI −12.0 to −6.8)2022
STEP-TEENSSemaglutideRandomised, double-blind, placebo-controlled20168 weeksMean change −16.1 % versus +0.6 % with placebo; estimated difference −16.7 percentage points (95 % CI −20.3 to −13.2)2022
AMPLITUDE-OExenatideEvent-driven cardiovascular outcome trial4,076Median 1.8 yearsHazard ratio 0.73 (95 % CI 0.58 to 0.92), with a composite kidney outcome also reduced2021
STEP-1SemaglutideRandomised, double-blind, placebo-controlled1,96168 weeksMean change −14.9 % with semaglutide 2.4 mg versus −2.4 % with placebo; treatment difference −12.4 percentage points (95 % CI −13.4 to −11.5)2021
STEP-2SemaglutideRandomised, double-blind, placebo-controlled1,21068 weeksMean change −9.6 % with semaglutide 2.4 mg versus −3.4 % with placebo; the effect is attenuated relative to STEP 1, which the Institute records as a consistent…2021
STEP-3SemaglutideRandomised, double-blind, placebo-controlled61168 weeksMean change −16.0 % with semaglutide 2.4 mg versus −5.7 % with placebo2021
STEP-4SemaglutideRandomised withdrawal80348 weeks after a 20-week run-inContinued treatment −7.9 % versus +6.9 % after switching to placebo; the Institute reads this as evidence that the effect is maintained by continued exposure…2021
AWARD-11DulaglutideRandomised, double-blind, active-controlled1,84236 weeksDose-dependent additional glycaemic and weight effect at 3.0 mg and 4.5 mg2020
SCALE-TEENSLiraglutideRandomised, double-blind, placebo-controlled25156 weeksEstimated difference in body-mass index standard-deviation score of −0.22 versus placebo2020
REWINDDulaglutideEvent-driven cardiovascular outcome trial9,901Median 5.4 yearsHazard ratio 0.88 (95 % CI 0.79 to 0.99)2019
AWARD-7DulaglutideRandomised, open-label, active-controlled57652 weeksNon-inferior glycaemic control with a smaller decline in eGFR than insulin glargine2018
HARMONY-OUTCOMESDulaglutideEvent-driven cardiovascular outcome trial9,463Median 1.6 yearsHazard ratio 0.78 (95 % CI 0.68 to 0.90)2018
SUSTAIN-7SemaglutideRandomised, double-blind, active-controlled1,20140 weeksDifference −0.41 percentage points (95 % CI −0.57 to −0.25) for semaglutide 1.0 mg versus dulaglutide 1.5 mg2018
EXSCELExenatideEvent-driven cardiovascular outcome trial14,752Median 3.2 yearsHazard ratio 0.91 (95 % CI 0.83 to 1.00); the trial did not meet its superiority threshold2017
SCALE-PREDIABETESLiraglutideRandomised, double-blind, placebo-controlled2,254160 weeksOnset in 2 % versus 6 % with placebo; hazard ratio 0.21 (95 % CI 0.13 to 0.34)2017
SUSTAIN-1SemaglutideRandomised, double-blind, placebo-controlled38830 weeksReduction of 1.5 percentage points with 1.0 mg versus 0.0 with placebo2017
24 included studies. Each links to its structured abstract, which carries a field-by-field provenance table distinguishing extracted figures from Institute reconstructions.

Contributing participants across studies reporting a randomised total: 74,597. Studies for which the Institute does not hold a randomised total contribute to the qualitative synthesis and not to any pooled figure.

§3.2Excluded at full text, with reasons

Table 5. Reports excluded at full text, by reason. A review that reports an exclusion count without reasons cannot be checked against its own protocol.

Reason for exclusionReports
Not a randomised comparison17
Population outside the review question6
Intervention outside the review question18
Comparator not eligible10
No eligible outcome reported7
Duplicate report of an included study12
Conference abstract without extractable data9
Retracted or subject to an expression of concern9
88 reports excluded at full text in total.

§3.3Risk of bias across included studies

Table 6. Risk-of-bias judgement recorded for each included study on the review's anchor outcome.

StudyRisk of biasInconsistencyIndirectnessImprecisionPublication bias
ESSENCELowLowSomeLowLow
EXENATIDE-GE-PDLowSomeLowLowLow
STRIDELowLowSomeLowLow
FLOWLowLowLowLowLow
STEP-HFpEF-DMLowLowLowLowSome
SELECTLowLowLowLowLow
STEP-HFpEFLowLowLowLowSome
STEP-5LowLowLowLowLow
STEP-8LowLowLowLowLow
STEP-TEENSSomeLowLowLowLow
AMPLITUDE-OLowLowLowSomeLow
STEP-1LowLowLowLowLow
STEP-2LowLowLowLowLow
STEP-3LowLowLowLowLow
Judgements are the Institute's own and are recorded per outcome. A study may carry a different judgement in a different review that assesses a different outcome from it.
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