{
  "schema_version": "1.0",
  "last_updated": "2026-07-08",
  "drug_class": "GLP-1 and dual GIP/GLP-1 receptor agonists",
  "trials": [
    {
      "name": "SURMOUNT-1",
      "drug": "tirzepatide",
      "population": "adults with obesity, without diabetes",
      "n": 2539,
      "duration_weeks": 72,
      "results": {
        "5mg": "15.0% mean weight reduction",
        "10mg": "19.5%",
        "15mg": "20.9%",
        "placebo": "3.1%"
      },
      "evidence_level": "high-quality RCT",
      "citation": "Jastreboff AM et al., NEJM 2022"
    },
    {
      "name": "SURMOUNT-5",
      "drug": "tirzepatide vs semaglutide",
      "population": "adults with obesity, without diabetes",
      "duration_weeks": 72,
      "results": {
        "tirzepatide": "20.2% mean weight reduction",
        "semaglutide": "13.7%"
      },
      "evidence_level": "high-quality RCT",
      "citation": "head-to-head trial, 2025"
    },
    {
      "name": "SURMOUNT-OSA",
      "drug": "tirzepatide",
      "population": "adults with obesity and moderate-to-severe obstructive sleep apnea",
      "evidence_level": "high-quality RCT",
      "note": "significant reduction in apnea-hypopnea index"
    },
    {
      "name": "SURPASS program",
      "drug": "tirzepatide",
      "population": "adults with type 2 diabetes",
      "evidence_level": "high-quality RCT",
      "note": "A1C and weight reductions across SURPASS-1 through SURPASS-5"
    },
    {
      "name": "STEP 1",
      "drug": "semaglutide 2.4mg",
      "population": "adults with obesity, without diabetes",
      "n": 1961,
      "duration_weeks": 68,
      "results": {
        "semaglutide": "14.9% mean weight reduction",
        "placebo": "2.4%"
      },
      "evidence_level": "high-quality RCT",
      "citation": "Wilding JPH et al., NEJM 2021",
      "note": "comparator context for tirzepatide"
    },
    {
      "name": "SELECT",
      "drug": "semaglutide 2.4mg",
      "population": "adults with CVD and overweight/obesity, without diabetes",
      "n": 17604,
      "results": {
        "MACE_reduction": "20%"
      },
      "evidence_level": "high-quality RCT",
      "citation": "Lincoff AM et al., NEJM 2023",
      "note": "cardiovascular outcomes context"
    },
    {
      "name": "Retatrutide Phase 2",
      "drug": "retatrutide (investigational triple agonist)",
      "population": "adults with obesity",
      "evidence_level": "phase 2 RCT",
      "note": "~24% mean weight reduction at highest dose; investigational, not FDA-approved"
    },
    {
      "name": "FLOW",
      "drug": "semaglutide 1.0mg",
      "population": "type 2 diabetes and chronic kidney disease",
      "n": 3533,
      "results": {
        "kidney_event_reduction": "24%"
      },
      "evidence_level": "high-quality RCT",
      "citation": "Perkovic V et al., NEJM 2024",
      "note": "renal outcomes context"
    }
  ]
}