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A Real-World Ranking of Five GLP-1 Shots Put Tirzepatide First

In 14,046 diverse US patients, tirzepatide took off about 13 percent of body weight in a year, semaglutide about 6, and the three older GLP-1 shots tied near 4. The trial ordering held, but tirzepatide's lead rests on just 386 people.

15d ago · GLP-1 · @pavel GLP-1RGIPR 4 min read
GLP-1 Drugs Cut Overdose Risk vs Insulin, Not vs Metformin

In veterans with diabetes and opioid use disorder, semaglutide and tirzepatide beat insulin and SGLT2 inhibitors on 12-month overdose risk but tied metformin, sulfonylureas, and DPP-4 drugs. The verdict flips with the comparator.

23d ago · GLP-1 · @pavel GLP-1R 3 min read
No blood-cancer signal for GLP-1 drugs in 100,000 matched veteran pairs

A Veterans Affairs cohort of 100,038 matched pairs found GLP-1 drugs tied to no more and no fewer lymphomas, leukemias, or myelomas than an older diabetes pill. Every confidence interval crossed the line of no difference.

24d ago · GLP-1 · @pavel GLP-1RANTICANCER 3 min read
In older Zepbound users, the frailty everyone feared was rarest

A data firm's analysis of nearly 30,000 adults 65 and older on tirzepatide found progressive muscle loss in 0.16 percent, with most frailty signals emerging only after six months.

25d ago · GLP-1 · @pavel GLP-1RGIPR 3 min read
Capping semaglutide's tip steered it toward the arm that lowers sugar

A Cell Reports team acetylated the N-terminus of GLP-1 and semaglutide to build G protein-biased receptor agonists that recruit less beta-arrestin, and a 2.64 angstrom cryo-EM structure pins the bias to an outward swing of extracellular loop 3. Ac-semaglutide kept lowering glucose in obese mice three days after one dose.

26d ago · GLP-1 · @pavel GLP-1R 4 min read
Semaglutide beat liraglutide on new diabetes, but only after six months

A target trial emulation of 57,456 weight-management patients found semaglutide users had a 12 percent lower one-year risk of new diabetes than liraglutide users (HR 0.88). The gap was absent in the first six months (HR 0.99) and only emerged after (HR 0.80). With just 57 cardiovascular events, the study had no power to compare heart risk.

26d ago · GLP-1 · @pavel GLP-1R 4 min read
Tirzepatide users had fewer lung and leg clots in a large cohort

In 235,200 matched adults, starting tirzepatide tracked with about three-quarters lower pulmonary embolism risk than lifestyle changes alone. The edge shrank to near even against semaglutide.

28d ago · GLP-1 · @pavel GLP-1RGIPR 3 min read
GLP-1 plus empagliflozin beat adding an older pill on heart risk

A US claims study emulating a randomized trial found that whichever flagship diabetes drug patients started on, adding the other modern class lowered heart events more than adding an older pill.

29d ago · GLP-1 · @pavel GLP-1R 3 min read
Genes tied to GLP-1 drugs point to less depression, not more

A drug-target Mendelian randomization study put major depression 18 percent lower and bipolar disorder 39 percent lower for genetically predicted GLP-1 receptor activation, cutting against two years of psychiatric-safety scares built on observational data.

Jul 14, 2026 · GLP-1 · @pavel GLP-1R 4 min read
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