SynthesisBMC pharmacology & toxicology2026

Effect of oral semaglutide on cardiometabolic risk factors in overweight and obese individuals with or without diabetes: a systematic review and meta-analysis.

Niloofar Seighali, Mohammad Sadra Gholami-Chahkand, Mandana Ebrahimzade, Farzin Tahmasbi Arashlow, Seyede Parmis Maroufi, Parnian Rahnama, Mohammad Hassan Matin, Alireza Khodayari Javazm, Pouya Ebrahimi, Khurram Nasir and 3 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC pharmacology & toxicology, 2026. The graph read 1 number from its abstract, feeding 1 cell of the map: it supports the treatment in 1. Cited by 1 paper.

1number the graph read from it
1cell of the map it votes in
1citing papers in PubMed
–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.

← favours the treatmentfavours the comparator →
1 · no effect
Cardiovascular eventsfavours the treatment · against placebo · t2d, obesityfeeds one cell of the map
OR 0.64p = 0.006
Semaglutide also showed a protective effect on cardiovascular events (OR = 0.64; p = 0.006).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×cardiovascular events

SupportsOpen on the map →What to test next →

13 readable studies in this cell: 7 favour the treatment, 2 find no difference, 4 favour the comparator.

Belief with this paper
0.50contested · 7 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0399313226,774 enrolled · 2018
HR 1.010.91 to 1.11
NCT0357459717,604 enrolled · 2018
HR 0.800.72 to 0.89
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
OR 1.951.28 to 3.00
NCT05564039282 enrolled · 2022
OR 20.48.40 to 49.8

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · 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.

5 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
6 · The record

Corrections and comments

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

7 · Who and what money

Authors and funding

13 authors.

Niloofar SeighaliTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-8862-6029
Mohammad Sadra Gholami-ChahkandTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-5710-2142
Mandana EbrahimzadeTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0004-8632-4723
Farzin Tahmasbi ArashlowTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-0953-7686
Seyede Parmis MaroufiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Parnian RahnamaTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0007-2128-0274
Mohammad Hassan MatinTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0003-7872-3655
Alireza Khodayari JavazmTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0003-4803-6299
Pouya EbrahimiCardiology Specialty Registry, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
Khurram NasirCenter for Cardiovascular Computational and Precision Health (C3PH), Houston Methodist, TX, USA.
Rosy ThachilDepartment of Cardiology, Elmhurst Hospital Center/Mount Sinai School of Medicine, Elmhurst, NY, USA.
Tor Biering SørensenDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Kaveh HosseiniTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. kaveh_hosseini130@yahoo.com.ORCID http://orcid.org/0000-0001-5676-3099

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundObesity is linked to cardiometabolic risk, and semaglutide, a glucagon-like peptide-1 receptor agonist, has emerged as a promising option for weight and metabolic control. This systematic review and meta-analysis evaluated the effects of oral semaglutide, compared with placebo, on cardiometabolic risk factors in overweight and obese adults with or without diabetes. MATERIALS AND

methodsIn this systematic review and meta-analysis, following PRISMA 2020 guidelines, PubMed, Embase, and Scopus were searched through 25 August 2025. Randomized controlled trials (RCT) with overweight and obese populations, with or without diabetes, were included. The treatment and control groups received oral semaglutide and placebo, respectively. Outcomes were cardiometabolic factors and adverse events at baseline and follow-up. We pooled data using a random-effects model to estimate changes in outcomes by reporting Estimated Treatment Difference (ETD) as mean difference. Subgroup analyses were conducted based on dosage and follow-up duration.

resultsThirteen RCTs involving 26,284 participants met the criteria (52% received semaglutide). Female ratio of the semaglutide group was 30.1% and for the placebo group weas 33.3%. Compared with placebo, semaglutide showed significant reductions in body weight (ETD - 2.85 kg; 95% CI [- 4.03 to - 1.66]; p < 0.001), BMI (ETD - 0.66 kg/m²; 95% CI [- 0.95 to - 0.36]; p < 0.001), waist circumference (ETD - 1.79 cm; 95% CI [- 2.63 to - 0.95]; p < 0.001), HbA1c (ETD - 0.94%; 95% CI [- 1.13 to - 0.76]; p < 0.001), fasting plasma glucose (ETD - 26.91 mg/dL; 95% CI [- 33.56 to - 20.26]; p < 0.001), systolic blood pressure (ETD - 2.71 mmHg; 95% CI [- 3.70 to - 1.72]; p < 0.001), and diastolic blood pressure (ETD - 0.77 mmHg; 95% CI [- 1.38 to - 0.17]; p = 0.01) over 6 months. Benefits were consistent across different follow-up durations and doses. Gastrointestinal symptoms remained the most common adverse events (OR for GI issues = 2.69; nausea = 3.13; vomiting = 6.25; all p < 0.001). Semaglutide also showed a protective effect on cardiovascular events (OR = 0.64; p = 0.006).

conclusionOral semaglutide demonstrates meaningful improvements in cardiometabolic outcomes and a favorable safety profile, supporting its use as a non-invasive therapy for obesity and related metabolic disorders.

Indexed as

Diabetes MellitusGlucagon-Like PeptidesHypoglycemic AgentsObesityOverweightAdministration, OralCardiometabolic Risk FactorsHumansRandomized Controlled Trials as TopicSemaglutideGlucagon-Like PeptidesHypoglycemic AgentsSemaglutideBody weightCardiometabolic risk factorsMeta-analysisObesitySemaglutideSystematic review

Identifiers

PMID42163419
PMCPMC13371186

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.