Evidence map›Paper›PMID 39608857›Full record

SynthesisBMJ global health2024

Representation of racialised and ethnically diverse populations in multicentre randomised controlled trials of GLP-1 medicines for obesity: a systematic review and meta-analysis of gaps.

Yaanu Jeyakumar, Lisa Richardson, Shohinee Sarma, Ravi Retnakaran, Caroline K Kramer

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Review
  7. GLP-1 guidelines amid an obesity epidemic: a poor fit for the Global South.Archives of public health = Archives belges de sante publique · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yaanu JeyakumarMount Sinai Hospital, Toronto, Ontario, Canada.
Lisa RichardsonUniversity of Toronto, Toronto, Ontario, Canada.
Shohinee SarmaUniversity of Toronto, Toronto, Ontario, Canada.
Ravi RetnakaranMount Sinai Hospital, Toronto, Ontario, Canada.
Caroline K KramerMount Sinai Hospital, Toronto, Ontario, Canada caroline.kramer@sinaihealth.ca.ORCID http://orcid.org/0000-0003-1064-0100

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTrials of GLP-1 (glucagon-like peptide-1) medicines have changed the paradigm of obesity treatment. Diversity in trial participation is imperative considering that obesity disproportionately impacts marginalised populations worldwide. We performed a systematic review and meta-analyses to evaluate the representation of racialised and ethnically diverse populations in randomised controlled trials (RCTs) of GLP-1 medicines for obesity.

methodsWe searched PubMed/Embase/ClinicalTrials.gov. Prevalence of each racial/ethnic group was compared in relation to the USA, Canada, the UK, Brazil and South Africa. The geographical locations of the trial sites were extracted.

results27 RCTs were identified (n=21 547 participants). Meta-analyses of prevalence demonstrated the vast predominance of white/Caucasians (79%) with smaller proportion of blacks (9%), Asians (13%), Indigenous (2%) and Hispanics (22%). The gaps in representation were evidenced by the significantly under-represented proportion of non-white individuals in these RCTs as compared with the prevalence of non-white individuals in the general population of the USA (-23%, p=0.002) and Canada (-34%, p<0.0001), reaching an alarming gap of -58% in relation to Brazil and striking under-representation of -68% as compared with South Africa. Similar discrepancies in proportions of blacks, Asians and Indigenous peoples as compared with reference nations were found. Moreover, the trial sites (n=1859) were predominately located in high-income countries (84.2%), in sharp contrast to the global prevalence of obesity that is predominantly in low-income and middle-income countries.

conclusionThere are discrepancies in representation of racialised and ethnically diverse populations in obesity trials as compared with multiethnic populations worldwide. These data highlight the need for broader reform in the research process in order to ultimately address health inequities.

Indexed as

EthnicityObesityRacial GroupsCanadaGlucagon-Like Peptide 1HumansMulticenter Studies as TopicRandomized Controlled Trials as TopicSouth AfricaUnited StatesGlucagon-Like Peptide 1Global HealthSystematic review

Identifiers

PMID39608857
PMCPMC11603712

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.