32 findings across 5 drug records. Domain pages are descriptive indexes, not advice.
Most represented records
Semaglutide (11)
Tirzepatide (10)
Liraglutide (5)
GLP-1 RA class (5)
Retatrutide (1)
Evidence spread
High evidence 18Moderate evidence 10Low evidence 4Very low evidence 0
SemaglutideMARKETED
special-populationsIncrease
Moderate evidence
In a PCOS RCT, adding semaglutide to metformin raised the natural pregnancy rate (35% vs 15%) in anovulatory women.
SourceSemaglutide+metformin in PCOS (open-label RCT, n=100), Reprod Biol Endocrinol 2025Source
PopulationPCOS open-label RCT (NCT not stated; Reprod Biol Endocrinol 2025): 100 overweight/obese women with PCOS (Rotterdam criteria), prospective randomised controlled open-label trial of semaglutide 1 mg weekly plus metformin vs metformin alone, 16 weeks.
Fundingacademic/government - Chinese government and institutional grants (Chongqing Health Commission/Science & Technology Bureau; NSFC; not industry)
Scope limitsWEIGHT/OVULATION-MEDIATED in a PCOS-anovulatory population (a channel absent in already-ovulatory women); open-label, small. Context-distinct from the general fertility-care cohort - the honest compendium statement is that the effect on fertility is context-dependent, not one-way.
SemaglutideMARKETED
special-populationsDecrease
Low evidence
In a matched real-world cohort, semaglutide pretreatment before fertility care was associated with reduced and delayed conception, with miscarriage unchanged.
SourceSemaglutide pretreatment and fertility-care outcomes (PSM cohort), Reprod Biol Endocrinol...Source
Scope limitsCONTEXT-DISTINCT, both-poled with the PCOS conception-up RCT (different population). This cohort signal is confounded by required washout/discontinuation timing and indication - NOT a demonstrated direct anti-fertility drug effect. Do not state a one-way 'GLP-1 harms fertility'.
SemaglutideMARKETED
special-populationsNot directional
Low evidence
A measured human-milk PK study found subcutaneous semaglutide undetectable in breast milk, with a worst-case relative infant dose of 1.26% - converting the lactation...
SourceSemaglutide human breast-milk transfer study (n=8), Nutrients 2024Source
Full findingA measured human-milk PK study found subcutaneous semaglutide undetectable in breast milk, with a worst-case relative infant dose of 1.26% - converting the lactation question from never-measured to measured-negligible FOR SEMAGLUTIDE.
Fundingacademic / investigator - University Medical Centre Ljubljana grant P3-0298
Scope limitsWEIGHT/HPG-MEDIATED (the most mechanistically interesting male signal, but still in an obesity-weight context); small, open-label.
TirzepatideMARKETED
special-populationsIncrease
Low evidence
In obese men with metabolic hypogonadism, tirzepatide improved erectile function and raised testosterone, outperforming testosterone replacement on axis recovery.
SourceTirzepatide on erectile function and hypogonadism (controlled non-randomised pilot, n=83)...Source
Scope limitsWEIGHT/TESTOSTERONE-CONFOUNDED and NON-randomised with baseline imbalances and self-report IIEF-5 - NOT a demonstrated direct drug effect; contradicted by the null RCT/infusion data. Graded low (non-randomised; not high).
TirzepatideMARKETED
special-populationsDecrease
Low evidence
Tirzepatide was associated with lower incident erectile dysfunction than several comparators in T2D men.
Scope limitsRelative-to-comparator (not vs placebo); confounded by indication/weight; coding-based outcome. Weight/testosterone-mediated, consistent with the other male signals.
GLP-1 RA classMARKETED
special-populationsDecrease
Moderate evidence
Pooled RCT data found GLP-1 RAs modestly lower total testosterone and BMI in obese PCOS women.
SourceGLP-1 RA and androgens in PCOS (meta-analysis, 4 RCTs), J Diabetes Complications 2024Source
Fundingacademic / investigator - no industry sponsor disclosed
Scope limitsSmall/fragile pool (p=0.03, mostly liraglutide, total-T only); any drop is plausibly SHBG/weight-mediated, not a demonstrated direct anti-androgen effect. CONTESTED by a broader meta finding androgens unchanged - both poles stand.
GLP-1 RA classMARKETED
special-populationsNo change
Moderate evidence
A broader PCOS RCT meta-analysis found GLP-1 RAs improve weight and insulin resistance but do NOT change circulating androgens.
SourceGLP-1 RA in PCOS, broad androgen panel (meta-analysis), Sci Rep 2025Source
Fundingacademic-Guangxi colleges teacher research grant (2023KY0576)
Scope limitsNet verdict across the two metas: metabolic improvement yes; androgen effect uncertain/small and at most SHBG/weight-mediated. Both-poled with the androgen-down meta.
GLP-1 RA classMARKETED
special-populationsDecrease
Moderate evidence
A 2025 meta-analysis of 25 RCTs confirms a modest class-level benefit of GLP-1 RAs added to insulin in T1D (HbA1c about -0.23%, weight -3.9kg, insulin -5.7 U/day), but...
SourceRebelos E, Anastasiou IA, Tentolouris N, Karagiannis T, Tsapas A, Ferrannini E, Liakos A....Source
Full findingA 2025 meta-analysis of 25 RCTs confirms a modest class-level benefit of GLP-1 RAs added to insulin in T1D (HbA1c about -0.23%, weight -3.9kg, insulin -5.7 U/day), but the pooled estimate is effectively liraglutide.
PopulationGLP-1 RA add-on T1D meta-analysis (Rebelos/Liakos et al., 25 RCTs, 3,224 patients; PMC12678461).
Fundingacademic/independent (Greek/Italian university authors; no manufacturer sponsor)
Scope limitsLIRAGLUTIDE-WEIGHTED: the 'class' estimate is dominated by liraglutide trials - do NOT transfer to other agents (non-liraglutide agents are ineffective on HbA1c, see C-CLASS-T1D-02). The review also found GLP-1 RAs do NOT prevent progressive C-peptide loss and counter-regulatory glucagon stays intact. High heterogeneity for insulin dose/TIR (I2~71%).
Comparatorsplacebo (insulin background)
GLP-1 RA classMARKETED
special-populationsDecrease
Moderate evidence
A 2023 meta-analysis corroborates the modest class benefit and shows the HbA1c effect is essentially confined to liraglutide - exenatide, exenatide-ER and albiglutide...
SourceTan X, Pan X, Wu X, Zheng S, Chen Y, Liu D, Zhang X. Glucagon-like peptide-1 receptor ago...Source
Full findingA 2023 meta-analysis corroborates the modest class benefit and shows the HbA1c effect is essentially confined to liraglutide - exenatide, exenatide-ER and albiglutide had no significant glycaemic effect - underlining that 'class' is effectively liraglutide.
PopulationGLP-1 RA add-on T1D meta-analysis (Tan et al., 11 RCTs, 2,856 patients; PMC10797415).
Fundingacademic/government (Central South University, China; Hunan provincial science foundations)
Scope limitsLiraglutide-specific -0.26% and the exenatide/exenatide-ER/albiglutide NULL were confirmed in the PMC full text (not just abstract). Subgroup: HbA1c effect larger in obese/overweight (-0.43%) than normal-weight (-0.10%, NS) T1D - the only suggestion of phenotype-dependence, against Dejgaard's BMI-null (different cut/method). Reinforces liraglutide-weighting (C-CLASS-T1D-01).
Comparatorsplacebo (insulin background)
LiraglutideMARKETED
special-populationsNo change
Moderate evidence
Heavier (overweight/obese) type-1 patients did NOT get greater benefit from liraglutide: in a pooled post-hoc, effects on HbA1c, weight and insulin did not differ by...
SourceDejgaard TF, von Scholten BJ, Christiansen E, et al. Efficacy and safety of liraglutide i...Source
Full findingHeavier (overweight/obese) type-1 patients did NOT get greater benefit from liraglutide: in a pooled post-hoc, effects on HbA1c, weight and insulin did not differ by baseline BMI - the 'double diabetes' rationale for targeting obese T1D is not supported by this subgroup.
No GLP-1 receptor agonist is approved for type-1 diabetes - every use is off-label, consistent with the pivotal-trial investigators concluding the safety signals limit...
SourceMathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and Safety of Liraglutide Added to I...Source
Full findingNo GLP-1 receptor agonist is approved for type-1 diabetes - every use is off-label, consistent with the pivotal-trial investigators concluding the safety signals limit clinical use. This is inferred from the trial conclusions, not a primary regulator document.
PopulationLiraglutide pivotal T1D RCTs (Mathieu ADJUNCT ONE; Ahren ADJUNCT TWO); regulatory-status inferred, not primary-sourced this pass.
Fundingindustry - Novo Nordisk (sponsor; NCT01836523)
Scope limitsCONFIDENCE MEDIUM / INFERRED: regulator status derived from the trialists' 'limiting clinical use' conclusion and the lack of any T1D indication, NOT a primary ADA/EASD/NICE/EMA/FDA citation. Flagged to OQ-T1D-C (add a primary guideline/regulator doc).
Comparatorsplacebo (insulin background)
LiraglutideMARKETED
special-populationsDecrease
Moderate evidence
A pooled post-hoc of the two pivotal trials shows the placebo-adjusted HbA1c reduction peaked near -0.30/-0.35% at week 26 then waned by week 52 - so the larger...
SourceDejgaard TF, von Scholten BJ, Christiansen E, et al. Efficacy and safety of liraglutide i...Source
Full findingA pooled post-hoc of the two pivotal trials shows the placebo-adjusted HbA1c reduction peaked near -0.30/-0.35% at week 26 then waned by week 52 - so the larger week-26 figure should not be headlined over the smaller 52-week primary endpoint.
PopulationPooled ADJUNCT ONE/TWO post-hoc analysis (Dejgaard et al., 2021; PMC9292057).
Fundingindustry+academic (Novo Nordisk sponsor; Steno Diabetes Center Copenhagen)
In the two pivotal double-blind RCTs, liraglutide added to insulin in type-1 diabetes produced a small, dose-dependent placebo-adjusted HbA1c reduction (about -0.2% at...
SourceMathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and Safety of Liraglutide Added to I...Source
Full findingIn the two pivotal double-blind RCTs, liraglutide added to insulin in type-1 diabetes produced a small, dose-dependent placebo-adjusted HbA1c reduction (about -0.2% at the top dose over 52 weeks), significant only at the higher doses - a modest glycaemic benefit.
PopulationLiraglutide pivotal double-blind T1D RCTs (Mathieu et al., ADJUNCT ONE, 52wk, n=1,398, 3:1, NCT01836523; corroborated by Ahren et al., ADJUNCT TWO, 26wk, n=835, NCT02098395).
Fundingindustry - Novo Nordisk (sponsor; NCT01836523)
Scope limitsModest magnitude; HbA1c benefit waned over 52wk (peak at wk26, see C-CLASS-T1D-PEAK-01). This is the efficacy pole that must be read SIDE-BY-SIDE with the HIGH-graded disease-specific harm (C-LIRA-T1D-SAFETY-01/02).
Comparatorsplacebo (insulin background)
LiraglutideMARKETED
special-populationsDecrease
High evidence
Liraglutide added to insulin in type-1 diabetes produced significant weight loss at every dose (about -5kg at the top dose) and a modest reduction in total insulin...
SourceMathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and Safety of Liraglutide Added to I...Source
Full findingLiraglutide added to insulin in type-1 diabetes produced significant weight loss at every dose (about -5kg at the top dose) and a modest reduction in total insulin requirement - the metabolic benefits beyond glycaemia.
Fundingindustry - Novo Nordisk (sponsor; NCT01836523)
Scope limitsWeight/insulin benefits are the most consistent efficacy signal (all doses), unlike the dose-gated HbA1c effect. Still off-label and still attended by the disease-specific harm signals.
Comparatorsplacebo (insulin background)
RetatrutideINVESTIGATIONAL
special-populationsNot directional
Moderate evidence
EXPLICIT ABSENCE: there is no retatrutide data in type-1 diabetes of any kind. Unlike liraglutide (two pivotal RCTs) and tirzepatide (one phase-2 trial), retatrutide...
SourceJastreboff AM et al. (retatrutide phase 2), NEJM, 2023;389:514-526Source
Full findingEXPLICIT ABSENCE: there is no retatrutide data in type-1 diabetes of any kind. Unlike liraglutide (two pivotal RCTs) and tirzepatide (one phase-2 trial), retatrutide has not been studied as an insulin adjunct in T1D - a complete void, not a measured-null.
PopulationRetatrutide evidence base reviewed for any type-1-diabetes indication (pinned to the phase-2 obesity trial, Jastreboff et al., NCT04881760, as the reviewed-for-indication anchor) - none present.
Scope limitsregulatory label; reflects approved labelling, not an independent effect estimate
SemaglutideMARKETED
special-populationsNot directional
High evidence
US labelling states there are no data on the presence of semaglutide in human milk; in lactating rats it was detected in milk at 3-12-fold lower levels than maternal...
SourceWegovy (semaglutide) US Prescribing Information, Novo NordiskSource
Full findingUS labelling states there are no data on the presence of semaglutide in human milk; in lactating rats it was detected in milk at 3-12-fold lower levels than maternal plasma, and advises weighing breastfeeding benefits against clinical need.
Scope limitsregulatory label; reflects approved labelling, not an independent effect estimate
SemaglutideMARKETED
special-populationsIncrease
High evidence
Animal reproduction studies show embryofetal mortality, structural abnormalities and growth alterations across rat, rabbit and monkey at exposures at or below the...
SourceOzempic (semaglutide) US Prescribing Information, Novo NordiskSource
Full findingAnimal reproduction studies show embryofetal mortality, structural abnormalities and growth alterations across rat, rabbit and monkey at exposures at or below the human dose; the label states human data are insufficient to establish a drug-associated risk and to discontinue when pregnancy is recognised.
Scope limitsregulatory label; reflects approved labelling, not an independent effect estimate
SemaglutideMARKETED
special-populationsNot directional
High evidence
No overall difference in effectiveness was observed between older (>=65) and younger adults; greater sensitivity of some older individuals cannot be ruled out.
SourceOzempic (semaglutide) US Prescribing Information, Novo NordiskSource
Scope limitsregulatory label; reflects approved labelling, not an independent effect estimate
SemaglutideMARKETED
special-populationsNot directional
High evidence
US labelling specifies no dose adjustment for renal impairment including ESRD (no clinically relevant PK change). 'No dose adjustment' is a label instruction, not a...
SourceOzempic (semaglutide) US Prescribing Information, Novo NordiskSource
Full findingUS labelling specifies no dose adjustment for renal impairment including ESRD (no clinically relevant PK change). 'No dose adjustment' is a label instruction, not a measured null.
Scope limitsregulatory label; reflects approved labelling, not an independent effect estimate
TirzepatideMARKETED
special-populationsNot directional
High evidence
A human lactation study (n=11) after a single 5 mg dose found tirzepatide largely undetectable in breast milk (cumulative <0.02% of the maternal dose); US labels make...
SourceZepbound (tirzepatide) US Prescribing Information, Eli LillySource
Full findingA human lactation study (n=11) after a single 5 mg dose found tirzepatide largely undetectable in breast milk (cumulative <0.02% of the maternal dose); US labels make no clinical-impact statement.
Scope limitsregulatory label; reflects approved labelling, not an independent effect estimate
TirzepatideMARKETED
special-populationsIncrease
High evidence
Animal reproduction studies show malformations and growth reductions in rat and rabbit at sub-clinical exposures; the label states human data are insufficient, and for...
SourceMounjaro (tirzepatide) US Prescribing Information, Eli Lilly; FDA/MHRA/TGA advisoriesSource
Full findingAnimal reproduction studies show malformations and growth reductions in rat and rabbit at sub-clinical exposures; the label states human data are insufficient, and for weight management (Zepbound) to discontinue when pregnancy is recognised.
Scope limitsanimal data; human relevance uncertain
TirzepatideMARKETED
special-populationsNot directional
High evidence
Paediatric status differs by product/region: the US Mounjaro label establishes use in T2D from age 10 (with higher vomiting/abdominal pain/hypoglycaemia than adults);...
SourceMounjaro (tirzepatide) US Prescribing Information, Eli Lilly; FDA/MHRA/TGA advisoriesSource
Full findingPaediatric status differs by product/region: the US Mounjaro label establishes use in T2D from age 10 (with higher vomiting/abdominal pain/hypoglycaemia than adults); Zepbound is not established in children, and the EU has not established use under 18.
Scope limitsanimal data; human relevance uncertain
TirzepatideMARKETED
special-populationsNot directional
High evidence
US labelling specifies no dose adjustment for renal impairment including ESRD, with advice to monitor renal function when initiating/escalating in patients with severe...
SourceMounjaro (tirzepatide) US Prescribing Information, Eli Lilly; FDA/MHRA/TGA advisoriesSource
Full findingUS labelling specifies no dose adjustment for renal impairment including ESRD, with advice to monitor renal function when initiating/escalating in patients with severe GI adverse reactions.
Scope limitsanimal data; human relevance uncertain
TirzepatideMARKETED
special-populationsDecrease
Moderate evidence
A single small phase-2 RCT (n=24, 12 weeks) found tirzepatide added to insulin in obese type-1 diabetes produced large weight loss (-8.7kg, 8.8%), a borderline HbA1c...
SourceSnaith JR, Frampton R, Samocha-Bonet D, Greenfield JR. Tirzepatide in Adults With Type 1 ...Source
Full findingA single small phase-2 RCT (n=24, 12 weeks) found tirzepatide added to insulin in obese type-1 diabetes produced large weight loss (-8.7kg, 8.8%), a borderline HbA1c reduction, and a 35% cut in insulin dose, with no significant adverse events - promising but very preliminary.
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