{
  "generated": "2026-09-23T22:00:40.480Z",
  "lastVerified": "2026-09-23",
  "site": "https://retatrutide-qa.pages.dev/",
  "sourceCount": 65,
  "claimCount": 158,
  "registryChecked": "2026-09-23",
  "sources": [
    {
      "citation": 1,
      "title": "Lilly's triple agonist, retatrutide, delivered powerful weight loss in pivotal Phase 3 obesity trial (TRIUMPH-1 topline)",
      "publisher": "Eli Lilly and Company via PR Newswire",
      "type": "Sponsor press release",
      "publication_date": "2026-05-21",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-powerful-weight-loss-in-pivotal-phase-3-obesity-trial-302778859.html",
      "claims": [
        {
          "claim": "TRIUMPH-1 weight change at 80 weeks, efficacy estimand (4/9/12 mg vs placebo)",
          "figure": "-19.0% / -25.9% / -28.3% vs -2.2%"
        },
        {
          "claim": "TRIUMPH-1 weight change at 80 weeks, treatment-regimen estimand",
          "figure": "-17.6% / -23.7% / -25.0% vs -3.9%"
        },
        {
          "claim": "12 mg absolute weight loss",
          "figure": "-31.9 kg (-70.3 lb)"
        },
        {
          "claim": "Participants reaching 30% or more weight loss",
          "figure": "15.3% / 37.9% / 45.3% vs 0.5%"
        },
        {
          "claim": "Participants reaching 25% and 35% or more weight loss",
          "figure": "25%: 27.8/52.9/62.5 vs 2.2%; 35%: 5.9/20.8/27.2 vs 0.3%"
        },
        {
          "claim": "Participants on 12 mg reaching BMI under 30",
          "figure": "65.3% (including 37.5% of those starting at BMI 40+)"
        },
        {
          "claim": "Waist circumference change from 118.3 cm",
          "figure": "-16.3 / -21.8 / -24.1 cm vs -3.6 cm"
        },
        {
          "claim": "104-week extension (n=532, BMI 35+), efficacy estimand",
          "figure": "-27.9% / -29.5% / -30.3% vs -19.2% (placebo switched to retatrutide)"
        },
        {
          "claim": "104-week extension, treatment-regimen estimand",
          "figure": "-25.7% / -28.7% / -29.9% vs -18.9%"
        },
        {
          "claim": "Randomized participants and baseline",
          "figure": "2,339; 112.7 kg; BMI 40.0"
        },
        {
          "claim": "Nausea, diarrhea, constipation, vomiting",
          "figure": "28.6/38.4/42.4 vs 14.8; 25.2/34.1/32.0 vs 13.5; 23.8/25.9/26.1 vs 10.9; 10.6/22.8/25.3 vs 4.8 (%)"
        },
        {
          "claim": "Dysesthesia and UTI",
          "figure": "5.1/12.3/12.5 vs 0.9%; 7.5/8.8/8.4 vs 5.3%"
        },
        {
          "claim": "Discontinuation due to adverse events",
          "figure": "4.1% / 6.9% / 11.3% vs 4.9%"
        },
        {
          "claim": "Titration",
          "figure": "Start 2 mg weekly, step every 4 weeks via 2, 4, 6, 9 mg"
        },
        {
          "claim": "Legal availability",
          "figure": "Legally available only to participants in Lilly's clinical trials"
        }
      ]
    },
    {
      "citation": 2,
      "title": "Retatrutide drove substantial improvements in weight, A1C, knee osteoarthritis pain and obstructive sleep apnea (ADA 2026)",
      "publisher": "Eli Lilly and Company via PR Newswire",
      "type": "Sponsor press release",
      "publication_date": "2026-06-06",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-drove-substantial-improvements-in-weight-a1c-knee-osteoarthritis-pain-and-obstructive-sleep-apnea-demonstrating-its-remarkable-potential-to-treat-obesity-and-its-complications-302793169.html",
      "claims": [
        {
          "claim": "TRIUMPH-1 non-HDL cholesterol reduction",
          "figure": "up to -24.2%"
        },
        {
          "claim": "TRIUMPH-1 knee OA basket WOMAC pain",
          "figure": "up to -4.3 points (-73.1%)"
        },
        {
          "claim": "TRANSCEND-T2D-1 cardiometabolic changes",
          "figure": "TG up to -39.6%; non-HDL-C up to -19.8%; SBP up to -6.4 mmHg; waist up to -12.4 cm"
        },
        {
          "claim": "TRANSCEND-T2D-1 dysesthesia and UTI",
          "figure": "4.5/2.3/4.4 vs 0.0%; 0.7/1.5/2.9 vs 0.0%"
        },
        {
          "claim": "Presentation venue",
          "figure": "ADA 86th Scientific Sessions; TRANSCEND-T2D-1 published simultaneously in The Lancet"
        }
      ]
    },
    {
      "citation": 3,
      "title": "TRIUMPH-1 ADA 2026 presentation (Jastreboff), HCP congress page and slide deck",
      "publisher": "Eli Lilly and Company (lilly.com HCP)",
      "type": "Congress presentation",
      "publication_date": "2026-06-06",
      "url": "https://www.lilly.com/hcp/congresses/ada-2026/dv039292-triumph-1",
      "claims": [
        {
          "claim": "OSA basket AHI change from 58.6 events/h, efficacy estimand (n=243)",
          "figure": "-25.7 / -36.1 / -33.8 vs -11.1"
        },
        {
          "claim": "OSA basket AHI change, treatment-regimen estimand",
          "figure": "-22.9 / -34.3 / -31.7 vs -9.9"
        },
        {
          "claim": "Knee OA basket WOMAC pain change from 6.0 (n=574), efficacy estimand",
          "figure": "-3.66 / -4.19 / -4.30 vs -2.24"
        },
        {
          "claim": "Serious adverse events",
          "figure": "7.7% / 7.7% / 10.5% vs 5.5%"
        },
        {
          "claim": "Deaths",
          "figure": "0 / 3 / 1 vs 2"
        },
        {
          "claim": "Triglycerides change from 121.0 mg/dL",
          "figure": "-34.0% / -40.8% / -41.0% vs -5.0%"
        },
        {
          "claim": "LDL cholesterol change from 112.8 mg/dL",
          "figure": "-15.1% / -20.3% / -19.6% vs -2.1%"
        },
        {
          "claim": "Systolic blood pressure change from 126.8 mmHg",
          "figure": "-8.5 / -11.3 / -12.3 vs -1.1 mmHg"
        },
        {
          "claim": "hsCRP change from 4.0 mg/L",
          "figure": "-57.9% / -63.5% / -63.8% vs -23.5%"
        },
        {
          "claim": "Prediabetes reverted to normoglycemia (36.1% had prediabetes)",
          "figure": "88.7% / 92.1% / 95.7% vs 48.7%"
        },
        {
          "claim": "UTI (single preferred term, slide)",
          "figure": "6.8% / 8.1% / 8.1% vs 4.8%"
        },
        {
          "claim": "Adverse events of special interest",
          "figure": "Hypotension-related 2.7/5.3/8.8 vs 0.9%; pancreatitis 0.2/0.5/0.7 vs 0.3%; serious or severe arrhythmia 0.2/0.7/0.9 vs 0.9%; injection-site reactions 5.5/8.9/12.2 vs 3.8%"
        },
        {
          "claim": "Discontinuation due to GI adverse events",
          "figure": "2.2% / 3.8% / 4.6% vs 1.2%"
        },
        {
          "claim": "Decreased appetite and dizziness",
          "figure": "12.8/13.4/16.5 vs 5.8%; 5.0/8.9/12.0 vs 3.1%"
        },
        {
          "claim": "Baseline BMI mix",
          "figure": "77.4% BMI 35+; 42.1% BMI 40+"
        },
        {
          "claim": "IWQOL-Lite-CT physical function",
          "figure": "+24.7 / +28.6 / +29.3 vs +11.9"
        }
      ]
    },
    {
      "citation": 4,
      "title": "Retatrutide successful in two additional Phase 3 obesity trials (TRIUMPH-2 and TRIUMPH-3 topline)",
      "publisher": "Eli Lilly and Company via PR Newswire",
      "type": "Sponsor press release",
      "publication_date": "2026-07-23",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c-302832674.html",
      "claims": [
        {
          "claim": "TRIUMPH-2 weight change at 80 weeks, efficacy estimand (n=1,152)",
          "figure": "-12.7% / -19.1% / -20.8% vs -4.0%"
        },
        {
          "claim": "TRIUMPH-2 HbA1c change from 7.7%",
          "figure": "-1.4 / -1.6 / -1.5 vs -0.2 points"
        },
        {
          "claim": "TRIUMPH-2 adverse events",
          "figure": "diarrhea 27.4/33.5/33.6 vs 13.2; nausea 13.7/20.8/28.0 vs 8.0; constipation 14.0/16.2/16.8 vs 9.4; vomiting 5.5/10.2/15.7 vs 4.2; dysesthesia 4.5/5.6/7.3 vs 0.7; UTI 3.8/6.3/8.0 vs 6.6 (%)"
        },
        {
          "claim": "TRIUMPH-2 discontinuation due to AEs",
          "figure": "3.8% / 11.6% / 7.7% vs 4.9%"
        },
        {
          "claim": "TRIUMPH-3 weight change at 80 weeks, efficacy estimand (n=1,949)",
          "figure": "-21.6% / -22.6% vs -3.2%"
        },
        {
          "claim": "TRIUMPH-3 risk factors at 12 mg",
          "figure": "TG -37.0%; non-HDL-C -16.5%; SBP -9.3 mmHg; waist -19.0 cm; hsCRP -51.2%"
        },
        {
          "claim": "TRIUMPH-3 MACE, pooled retatrutide vs placebo",
          "figure": "MACE-5 44 vs 52 events, HR 0.82 (0.55 to 1.22); MACE-3 27 vs 23 events, HR 1.12 (0.64 to 1.96)"
        },
        {
          "claim": "TRIUMPH-3 adverse events",
          "figure": "diarrhea 30.1/24.4 vs 8.7; nausea 21.7/22.4 vs 5.8; constipation 18.0/15.7 vs 7.1; hyperglycemia 3.9/3.1 vs 13.4; dysesthesia 6.4/6.4 vs 1.3; UTI 6.1/7.0 vs 5.3 (%)"
        },
        {
          "claim": "TRIUMPH-3 discontinuation due to AEs",
          "figure": "9.8% / 13.5% vs 4.8%"
        },
        {
          "claim": "Regulatory plan",
          "figure": "Completing CMC package for a BLA; US submission planned Q1 2027"
        },
        {
          "claim": "Planned indications",
          "figure": "Obesity, knee osteoarthritis pain, obstructive sleep apnea"
        },
        {
          "claim": "Program size",
          "figure": "More than 5,800 participants in initial TRIUMPH program"
        }
      ]
    },
    {
      "citation": 5,
      "title": "Retatrutide delivered weight loss of up to an average of 71.2 lbs along with substantial relief from osteoarthritis pain (TRIUMPH-4 topline)",
      "publisher": "Eli Lilly and Company via PR Newswire",
      "type": "Sponsor press release",
      "publication_date": "2025-12-11",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html",
      "claims": [
        {
          "claim": "TRIUMPH-4 weight change at 68 weeks, efficacy estimand (n=445)",
          "figure": "9 mg -26.4%; 12 mg -28.7% (-32.3 kg); placebo -2.1%"
        },
        {
          "claim": "TRIUMPH-4 weight change, treatment-regimen estimand",
          "figure": "-20.0% / -23.7% vs -4.6%"
        },
        {
          "claim": "WOMAC pain change from 6.0, efficacy estimand",
          "figure": "-4.5 (-75.8%) / -4.4 (-74.3%) vs -2.4 (-40.3%)"
        },
        {
          "claim": "WOMAC physical function change, efficacy estimand",
          "figure": "-4.1 / -4.2 vs -2.1"
        },
        {
          "claim": "Systolic blood pressure at 12 mg",
          "figure": "-14.0 mmHg"
        },
        {
          "claim": "Dysesthesia",
          "figure": "8.8% / 20.9% vs 0.7%"
        },
        {
          "claim": "GI adverse events",
          "figure": "nausea 38.1/43.2 vs 10.7; diarrhea 34.7/33.1 vs 13.4; constipation 21.8/25.0 vs 8.7; vomiting 20.4/20.9 vs 0.0 (%)"
        },
        {
          "claim": "Discontinuation due to AEs",
          "figure": "12.2% / 18.2% vs 4.0%; BMI 35+ subgroup 8.8/12.1 vs 4.8%"
        },
        {
          "claim": "Baseline",
          "figure": "84.0% BMI 35+; BMI 40.4"
        }
      ]
    },
    {
      "citation": 6,
      "title": "Retatrutide demonstrated significant reductions in A1C and weight in first Phase 3 trial for type 2 diabetes (TRANSCEND-T2D-1 topline)",
      "publisher": "Eli Lilly and Company via PR Newswire",
      "type": "Sponsor press release",
      "publication_date": "2026-03-19",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-demonstrated-significant-reductions-in-a1c-and-weight-in-first-phase-3-trial-for-treatment-of-type-2-diabetes-302718589.html",
      "claims": [
        {
          "claim": "HbA1c change from 7.9%, efficacy estimand",
          "figure": "-1.7 / -2.0 / -1.9 vs -0.8 points"
        },
        {
          "claim": "Weight change at 40 weeks, efficacy estimand",
          "figure": "-11.5% / -15.5% / -16.8% vs -2.5%"
        },
        {
          "claim": "GI adverse events",
          "figure": "nausea 16.4/19.5/26.5 vs 3.7; diarrhea 18.7/26.3/22.8 vs 4.5; vomiting 15.7/15.0/17.6 vs 2.2 (%)"
        },
        {
          "claim": "Discontinuation due to AEs",
          "figure": "2.2% / 4.5% / 5.1% vs 0.0%"
        }
      ]
    },
    {
      "citation": 7,
      "title": "Retatrutide monotherapy in type 2 diabetes (TRANSCEND-T2D-1), The Lancet 2026;407:2402-2413, doi 10.1016/S0140-6736(26)00967-0",
      "publisher": "The Lancet (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2026-06-06",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=42250575&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/42250575/",
      "claims": [
        {
          "claim": "Design",
          "figure": "n=537; 40 weeks; HbA1c 7.0 to 9.5%; BMI 23+; no glucose-lowering drugs for 90 days"
        },
        {
          "claim": "Weight change, treatment-regimen estimand",
          "figure": "-11.5% / -13.9% / -15.3% vs -2.6%"
        },
        {
          "claim": "HbA1c change, treatment-regimen estimand",
          "figure": "-1.69 / -1.86 / -1.94 vs -0.81"
        }
      ]
    },
    {
      "citation": 8,
      "title": "TRANSCEND-T2D-1 ADA 2026 presentation, HCP congress page",
      "publisher": "Eli Lilly and Company (lilly.com HCP)",
      "type": "Congress presentation",
      "publication_date": "2026-06-06",
      "url": "https://www.lilly.com/hcp/congresses/ada-2026/dv-036761-rt",
      "claims": [
        {
          "claim": "Participants reaching HbA1c under 7.0%",
          "figure": "84.0% / 88.9% / 90.4% vs 52.1%"
        },
        {
          "claim": "Participants reaching HbA1c under 5.7%",
          "figure": "36.6% / 45.7% / 39.0% vs 14.1%"
        },
        {
          "claim": "Serious AEs",
          "figure": "4.5% / 0.8% / 3.7% vs 1.5%; no severe hypoglycemia"
        }
      ]
    },
    {
      "citation": 9,
      "title": "Jastreboff AM et al. Triple-Hormone-Receptor Agonist Retatrutide for Obesity: A Phase 2 Trial. N Engl J Med 2023;389:514-526",
      "publisher": "New England Journal of Medicine (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2023-06-26",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37366315&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/37366315/",
      "claims": [
        {
          "claim": "Weight change at 48 weeks",
          "figure": "1 mg -8.7%; 4 mg -17.1%; 8 mg -22.8%; 12 mg -24.2%; placebo -2.1%"
        },
        {
          "claim": "Weight change at 24 weeks",
          "figure": "-7.2% / -12.9% / -17.3% / -17.5% vs -1.6%"
        },
        {
          "claim": "Reaching 5/10/15% loss at 48 weeks on 12 mg",
          "figure": "100% / 93% / 83% vs 27% / 9% / 2%"
        }
      ]
    },
    {
      "citation": 10,
      "title": "Jastreboff AM et al. NEJM 2023 phase 2 full text (NEJM media center PDF)",
      "publisher": "New England Journal of Medicine",
      "type": "Peer-reviewed journal",
      "publication_date": "2023-06-26",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
      "claims": [
        {
          "claim": "Receptor potency relative to native hormones",
          "figure": "GIP 8.9x; GLP-1 0.4x; glucagon 0.3x"
        },
        {
          "claim": "Half-life",
          "figure": "about 6 days"
        },
        {
          "claim": "Estimand used",
          "figure": "Efficacy estimand for reported results"
        },
        {
          "claim": "Eligibility",
          "figure": "Age 18 to 75; BMI 30 to 50, or 27 to under 30 with a weight-related condition; no diabetes"
        },
        {
          "claim": "Nausea by starting dose at 8 mg",
          "figure": "17% (2 mg start) vs 60% (4 mg start)"
        },
        {
          "claim": "12 mg adverse events vs placebo",
          "figure": "nausea 45 vs 11; diarrhea 15 vs 11; vomiting 19 vs 1; constipation 16 vs 3 (%)"
        },
        {
          "claim": "Discontinuation due to AEs",
          "figure": "6% to 16% retatrutide (16% at 12 mg) vs 0% placebo"
        },
        {
          "claim": "Skin sensation events",
          "figure": "7% retatrutide vs 1% placebo; 13% at 12 mg"
        },
        {
          "claim": "Cardiac arrhythmia AEs",
          "figure": "11% at 12 mg vs 3% placebo"
        },
        {
          "claim": "Heart rate",
          "figure": "Dose-dependent increase peaking at 24 weeks, then declining"
        },
        {
          "claim": "LDL cholesterol",
          "figure": "about 20% reduction"
        },
        {
          "claim": "Antihypertensive medication stopped",
          "figure": "41% (8 mg) and 30% (12 mg)"
        },
        {
          "claim": "Prediabetes reverting to normoglycemia",
          "figure": "72% vs 22%"
        },
        {
          "claim": "Waist circumference",
          "figure": "-6.5 to -19.6 cm vs -2.6 cm"
        },
        {
          "claim": "Serious adverse events",
          "figure": "4% in both groups"
        }
      ]
    },
    {
      "citation": 11,
      "title": "Sanyal AJ et al. Triple hormone receptor agonist retatrutide for metabolic dysfunction-associated steatotic liver disease. Nat Med 2024",
      "publisher": "Nature Medicine (PMC full text)",
      "type": "Peer-reviewed journal",
      "publication_date": "2024-06-10",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11271400/",
      "claims": [
        {
          "claim": "Liver fat relative change at 48 weeks",
          "figure": "8 mg -81.7%; 12 mg -86.0%; placebo -4.6%"
        },
        {
          "claim": "Liver fat relative change at 24 weeks",
          "figure": "8 mg -81.4%; 12 mg -82.4%; placebo +0.3%"
        },
        {
          "claim": "Normal liver fat (under 5%) at 48 weeks",
          "figure": "89% (8 mg) and 93% (12 mg)"
        },
        {
          "claim": "Substudy size and completeness",
          "figure": "98 participants; week-48 MRI for 43.9%"
        },
        {
          "claim": "Visceral fat change at 48 weeks",
          "figure": "-16.1% to -48.3% vs +2.5%"
        }
      ]
    },
    {
      "citation": 12,
      "title": "Rosenstock J et al. Retatrutide in type 2 diabetes: phase 2 trial. Lancet 2023",
      "publisher": "The Lancet (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2023-06-26",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37385280&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/37385280/",
      "claims": [
        {
          "claim": "HbA1c change at 24 weeks",
          "figure": "up to -2.02 points (12 mg)"
        },
        {
          "claim": "Weight change at 36 weeks",
          "figure": "up to -16.94% (12 mg)"
        },
        {
          "claim": "Size",
          "figure": "n=281"
        }
      ]
    },
    {
      "citation": 13,
      "title": "Coskun T et al. Body composition with retatrutide in type 2 diabetes (DXA substudy). Lancet Diabetes Endocrinol 2025",
      "publisher": "Lancet Diabetes and Endocrinology (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2025-06-30",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=40609566&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/40609566/",
      "claims": [
        {
          "claim": "Total fat mass reduction at 36 weeks",
          "figure": "8 mg 26.1%; 12 mg 23.2%; placebo 4.5%"
        },
        {
          "claim": "Evaluable participants",
          "figure": "103 with baseline and week-36 DXA"
        },
        {
          "claim": "Lean mass share",
          "figure": "Proportion of lean mass lost similar to other obesity treatments (qualitative)"
        }
      ]
    },
    {
      "citation": 14,
      "title": "Coskun T et al. LY3437943, a novel triple GIP, GLP-1 and glucagon receptor agonist. Cell Metab 2022",
      "publisher": "Cell Metabolism (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2022-08-18",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=35985340&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/35985340/",
      "claims": [
        {
          "claim": "Mechanism",
          "figure": "Glucagon receptor activity increased energy expenditure in mice"
        }
      ]
    },
    {
      "citation": 15,
      "title": "Urva S et al. LY3437943 in type 2 diabetes: phase 1b. Lancet 2022",
      "publisher": "The Lancet (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2022-11-26",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=36354040&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/36354040/",
      "claims": [
        {
          "claim": "Half-life",
          "figure": "about 6 days"
        }
      ]
    },
    {
      "citation": 16,
      "title": "TRIUMPH-1 registry record (NCT05929066)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-08-21",
      "url": "https://clinicaltrials.gov/study/NCT05929066",
      "claims": [
        {
          "claim": "Eligibility",
          "figure": "BMI 30+, or 27+ with hypertension, dyslipidemia, OSA or CVD; adults 18+; no diabetes"
        },
        {
          "claim": "OSA and OA baskets",
          "figure": "AHI 15+ on polysomnography; knee OA Kellgren-Lawrence grade 2 or 3"
        },
        {
          "claim": "Actual enrollment",
          "figure": "2,335"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "COMPLETED; enrollment 2335 (actual); primary completion 2026-04-06 (actual); results posted: no"
        }
      ]
    },
    {
      "citation": 17,
      "title": "TRIUMPH-2 registry record (NCT05929079)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-07-30",
      "url": "https://clinicaltrials.gov/study/NCT05929079",
      "claims": [
        {
          "claim": "Eligibility",
          "figure": "BMI 27+; type 2 diabetes on stable treatment 90+ days"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "COMPLETED; enrollment 1152 (actual); primary completion 2026-06-16 (actual); results posted: no"
        }
      ]
    },
    {
      "citation": 18,
      "title": "TRIUMPH-3 registry record (NCT05882045)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-07-30",
      "url": "https://clinicaltrials.gov/study/NCT05882045",
      "claims": [
        {
          "claim": "Eligibility",
          "figure": "BMI 35+ with prior MI, stroke or symptomatic PAD"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "COMPLETED; enrollment 1946 (actual); primary completion 2026-04-16 (actual); results posted: no"
        }
      ]
    },
    {
      "citation": 19,
      "title": "TRIUMPH-4 registry record (NCT05931367)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-01-21",
      "url": "https://clinicaltrials.gov/study/NCT05931367",
      "claims": [
        {
          "claim": "Eligibility",
          "figure": "BMI 27+; knee OA with Kellgren-Lawrence grade 2 or 3; no diabetes"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "COMPLETED; enrollment 445 (actual); primary completion 2025-11-14 (actual); results posted: no"
        }
      ]
    },
    {
      "citation": 20,
      "title": "TRIUMPH-5, retatrutide vs tirzepatide (NCT06662383)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-07-20",
      "url": "https://clinicaltrials.gov/study/NCT06662383",
      "claims": [
        {
          "claim": "Design",
          "figure": "Retatrutide vs tirzepatide; 80-week primary endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 800 (estimated); primary completion 2026-11 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 21,
      "title": "TRIUMPH-Outcomes, cardiovascular and kidney outcomes (NCT06383390)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-08-24",
      "url": "https://clinicaltrials.gov/study/NCT06383390",
      "claims": [
        {
          "claim": "Design",
          "figure": "Adults 45+ with BMI 27+ and ASCVD or CKD; event-driven cardiovascular and kidney endpoints"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 10000 (estimated); primary completion 2029-02 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 22,
      "title": "TRIUMPH-7, chronic low back pain (NCT07035093)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-07-23",
      "url": "https://clinicaltrials.gov/study/NCT07035093",
      "claims": [
        {
          "claim": "Design",
          "figure": "Chronic low back pain; pain and weight endpoints up to 72 weeks"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 586 (estimated); primary completion 2027-09 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 23,
      "title": "MASLD multi-agent master protocol (NCT07165028)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-09-22",
      "url": "https://clinicaltrials.gov/study/NCT07165028",
      "claims": [
        {
          "claim": "Design",
          "figure": "Retatrutide and tirzepatide arms vs placebo; major adverse liver outcomes endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "RECRUITING; enrollment 4500 (estimated); primary completion 2030-08 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 24,
      "title": "TRIUMPH-6, maintenance of weight reduction (NCT06859268)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-03-03",
      "url": "https://clinicaltrials.gov/study/NCT06859268",
      "claims": [
        {
          "claim": "Design",
          "figure": "80 weeks on dose 1, then 36 weeks on dose 1, dose 2 or placebo; 116-week endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 643 (estimated); primary completion 2028-04 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 25,
      "title": "TRIUMPH-9, dose-escalation schemes (NCT07357415)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-06-09",
      "url": "https://clinicaltrials.gov/study/NCT07357415",
      "claims": [
        {
          "claim": "Design",
          "figure": "Three escalation schemes; 104-week endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 600 (estimated); primary completion 2028-10 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 26,
      "title": "TRIUMPH-8 (NCT07232719)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-04-17",
      "url": "https://clinicaltrials.gov/study/NCT07232719",
      "claims": [
        {
          "claim": "Design",
          "figure": "Two doses vs placebo; 56-week endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 250 (estimated); primary completion 2027-07 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 27,
      "title": "Pre-approval expanded access of retatrutide (NCT07629401)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-08-06",
      "url": "https://clinicaltrials.gov/study/NCT07629401",
      "claims": [
        {
          "claim": "Criteria",
          "figure": "Adults with BMI 35+ despite highest available dose of chronic weight management therapy and 2+ serious obesity complications; unable to join a trial"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "AVAILABLE; enrollment n/a (n/a); primary completion n/a (n/a); results posted: no"
        }
      ]
    },
    {
      "citation": 28,
      "title": "TRANSCEND-T2D-1 registry record (NCT06354660)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-03-05",
      "url": "https://clinicaltrials.gov/study/NCT06354660",
      "claims": [
        {
          "claim": "Eligibility",
          "figure": "HbA1c 7.0% to 9.5%; BMI 23+; no glucose-lowering drugs for 90 days"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "COMPLETED; enrollment 537 (actual); primary completion 2026-01-22 (actual); results posted: no"
        }
      ]
    },
    {
      "citation": 29,
      "title": "TRANSCEND-T2D-2, retatrutide vs semaglutide (NCT06260722)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-04-13",
      "url": "https://clinicaltrials.gov/study/NCT06260722",
      "claims": [
        {
          "claim": "Design",
          "figure": "Participants on metformin; open-label vs semaglutide; 80-week HbA1c endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 1250 (estimated); primary completion 2026-08 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 30,
      "title": "TRANSCEND-T2D-3, type 2 diabetes with renal impairment (NCT06297603)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-07-20",
      "url": "https://clinicaltrials.gov/study/NCT06297603",
      "claims": [
        {
          "claim": "Design",
          "figure": "Participants on basal insulin with renal impairment; 52-week HbA1c endpoint"
        },
        {
          "claim": "Registry status (auto-synced 2026-09-23)",
          "figure": "ACTIVE_NOT_RECRUITING; enrollment 320 (estimated); primary completion 2026-10 (estimated); results posted: no"
        }
      ]
    },
    {
      "citation": 31,
      "title": "Eli Lilly Q2 2026 earnings call transcript",
      "publisher": "The Globe and Mail (transcript)",
      "type": "Earnings call transcript",
      "publication_date": "2026-08-05",
      "url": "https://www.theglobeandmail.com/investing/markets/stocks/LLY-N/pressreleases/3818844/eli-lilly-lly-q2-2026-earnings-call-transcript/",
      "claims": [
        {
          "claim": "Submission timing and classification dispute",
          "figure": "Q1 2027 BLA plan restated; classification described as active litigation"
        }
      ]
    },
    {
      "citation": 32,
      "title": "Eli Lilly Q2 2026 earnings presentation slides",
      "publisher": "Eli Lilly and Company (investor.lilly.com)",
      "type": "Sponsor investor materials",
      "publication_date": "2026-08-05",
      "url": "https://investor.lilly.com/static-files/ab69001c-650b-44f6-b629-309ee33f2335",
      "claims": [
        {
          "claim": "Submission timing",
          "figure": "Retatrutide submissions for obesity, OSA and knee OA now expected 2027"
        }
      ]
    },
    {
      "citation": 33,
      "title": "Lilly-FDA retatrutide biologic dispute comes to a head as submission nears",
      "publisher": "BioSpace",
      "type": "Trade press",
      "publication_date": "2026-08-05",
      "url": "https://www.biospace.com/fda/lilly-fda-retatrutide-biologic-dispute-comes-to-a-head-as-submission-nears",
      "claims": [
        {
          "claim": "Classification dispute",
          "figure": "FDA determined retatrutide is not a biological product; court vacated and remanded; Lilly appealed"
        },
        {
          "claim": "Exclusivity at stake",
          "figure": "BLA confers 12 years of market exclusivity"
        }
      ]
    },
    {
      "citation": 34,
      "title": "Can a new weight-loss treatment escape the legal and regulatory thicket?",
      "publisher": "Reason",
      "type": "Magazine",
      "publication_date": "2026-09-10",
      "url": "https://reason.com/2026/09/10/can-a-new-weight-loss-treatment-escape-the-legal-and-regulatory-thicket/",
      "claims": [
        {
          "claim": "Appeal schedule",
          "figure": "Seventh Circuit oral argument 24 Sep 2026 (not checked against the court docket)"
        }
      ]
    },
    {
      "citation": 35,
      "title": "Lilly calls on online platforms, payment companies and regulators to act against illegal retatrutide sellers",
      "publisher": "Eli Lilly and Company (investor.lilly.com)",
      "type": "Sponsor press release",
      "publication_date": "2026-08-12",
      "url": "https://investor.lilly.com/news-releases/news-release-details/lilly-calls-online-platforms-payment-companies-and-regulators",
      "claims": [
        {
          "claim": "Approval status",
          "figure": "Not approved for human use by any regulatory agency in the world"
        },
        {
          "claim": "Enforcement",
          "figure": "6 lawsuits filed against sellers"
        }
      ]
    },
    {
      "citation": 36,
      "title": "Lilly to present new data on Foundayo, retatrutide and eloralintide at EASD 2026",
      "publisher": "Eli Lilly and Company via PR Newswire",
      "type": "Sponsor press release",
      "publication_date": "2026-09-15",
      "url": "https://www.prnewswire.com/news-releases/lilly-to-present-new-data-on-foundayo-retatrutide-and-eloratzp-at-easd-2026-as-it-strives-to-change-the-course-of-cardiometabolic-health-302878341.html",
      "claims": [
        {
          "claim": "EASD symposium",
          "figure": "30 Sep 2026, Milan; TRIUMPH-2 featured"
        }
      ]
    },
    {
      "citation": 37,
      "title": "FDA's concerns with unapproved GLP-1 drugs used for weight loss",
      "publisher": "US Food and Drug Administration",
      "type": "Regulator",
      "publication_date": "2026-09-01",
      "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss",
      "claims": [
        {
          "claim": "Compounding",
          "figure": "Retatrutide cannot be used in compounding under federal law"
        }
      ]
    },
    {
      "citation": 38,
      "title": "Warning letter: GLP-1 Solution (715883)",
      "publisher": "US Food and Drug Administration",
      "type": "Regulator",
      "publication_date": "2025-09-09",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/glp-1-solution-715883-09092025",
      "claims": [
        {
          "claim": "Why retatrutide cannot be compounded",
          "figure": "Not eligible under section 503A or 503B"
        }
      ]
    },
    {
      "citation": 39,
      "title": "Warning letter: Peptide Partners LLC (735063)",
      "publisher": "US Food and Drug Administration",
      "type": "Regulator",
      "publication_date": "2026-08-24",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/peptide-partners-llc-735063-08242026",
      "claims": [
        {
          "claim": "Research-use-only retatrutide sales",
          "figure": "Warning letter dated 24 Aug 2026"
        }
      ]
    },
    {
      "citation": 40,
      "title": "Warning letter: Royal Peptides LLC (734884)",
      "publisher": "US Food and Drug Administration",
      "type": "Regulator",
      "publication_date": "2026-08-24",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/royal-peptides-llc-734884-08242026",
      "claims": [
        {
          "claim": "Status",
          "figure": "Retatrutide products are unapproved new drugs"
        }
      ]
    },
    {
      "citation": 41,
      "title": "Test purchases of semaglutide from illegal online pharmacies. J Med Internet Res 2024",
      "publisher": "Journal of Medical Internet Research (PMC)",
      "type": "Peer-reviewed journal",
      "publication_date": "2024-11-07",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11582493/",
      "claims": [
        {
          "claim": "Quality of illegally sold GLP-1 product",
          "figure": "Purity 7.7% to 14.37%; endotoxin in all samples; 3 vials tested"
        }
      ]
    },
    {
      "citation": 42,
      "title": "FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize",
      "publisher": "US Food and Drug Administration",
      "type": "Regulator",
      "publication_date": "2026-04-01",
      "url": "https://www.fda.gov/drugs/drug-alerts-and-statements/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize",
      "claims": [
        {
          "claim": "Shortages resolved",
          "figure": "Tirzepatide 19 Dec 2024; semaglutide 21 Feb 2025"
        }
      ]
    },
    {
      "citation": 43,
      "title": "Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med 2022;387:205-216",
      "publisher": "New England Journal of Medicine (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2022-06-04",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=35658024&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/35658024/",
      "claims": [
        {
          "claim": "Weight change at 72 weeks, treatment-regimen estimand",
          "figure": "-15.0% / -19.5% / -20.9% vs -3.1%"
        },
        {
          "claim": "Discontinuation due to AEs",
          "figure": "4.3% / 7.1% / 6.2% vs 2.6%"
        }
      ]
    },
    {
      "citation": 44,
      "title": "Lilly's SURMOUNT-1 results published in The New England Journal of Medicine",
      "publisher": "Eli Lilly and Company (investor.lilly.com)",
      "type": "Sponsor press release",
      "publication_date": "2022-06-04",
      "url": "https://investor.lilly.com/news-releases/news-release-details/lillys-surmount-1-results-published-new-england-journal-medicine",
      "claims": [
        {
          "claim": "Efficacy estimand weight change",
          "figure": "-16.0% / -21.4% / -22.5% vs -2.4%"
        },
        {
          "claim": "GI adverse events at 15 mg vs placebo",
          "figure": "nausea 31.0 vs 9.5; diarrhea 23.0 vs 7.3; vomiting 12.2 vs 1.7; constipation 11.7 vs 5.8 (%)"
        }
      ]
    },
    {
      "citation": 45,
      "title": "Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med 2021;384:989-1002",
      "publisher": "New England Journal of Medicine (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2021-02-10",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=33567185&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/33567185/",
      "claims": [
        {
          "claim": "Weight change at 68 weeks",
          "figure": "-14.9% vs -2.4%"
        },
        {
          "claim": "Discontinuation due to GI events",
          "figure": "4.5% vs 0.8%"
        }
      ]
    },
    {
      "citation": 46,
      "title": "STEP 1 registry results (NCT03548935)",
      "publisher": "ClinicalTrials.gov",
      "type": "Trial registry",
      "publication_date": "2026-09-23",
      "url": "https://clinicaltrials.gov/study/NCT03548935",
      "claims": [
        {
          "claim": "GI adverse events",
          "figure": "nausea 44.1 vs 17.4; diarrhea 31.5 vs 15.9; vomiting 24.6 vs 6.6; constipation 23.4 vs 9.5 (%)"
        }
      ]
    },
    {
      "citation": 47,
      "title": "Aronne LJ et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med 2025;393:26-36",
      "publisher": "New England Journal of Medicine (NCBI PubMed abstract)",
      "type": "Peer-reviewed journal",
      "publication_date": "2025-05-11",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=40353578&rettype=abstract&retmode=text",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/40353578/",
      "claims": [
        {
          "claim": "Weight change at 72 weeks",
          "figure": "-20.2% (tirzepatide) vs -13.7% (semaglutide)"
        }
      ]
    },
    {
      "citation": 48,
      "title": "Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide (STEP 1 extension). Diabetes Obes Metab 2022;24:1553-1564",
      "publisher": "Diabetes, Obesity and Metabolism (PMC full text)",
      "type": "Peer-reviewed journal",
      "publication_date": "2022-05-19",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/35441470/",
      "claims": [
        {
          "claim": "Regain one year after stopping",
          "figure": "11.6 of 17.3 percentage points regained"
        }
      ]
    },
    {
      "citation": 49,
      "title": "Aronne LJ et al. Continued treatment with tirzepatide for maintenance of weight reduction (SURMOUNT-4). JAMA 2024;331:38-48",
      "publisher": "JAMA (PMC full text)",
      "type": "Peer-reviewed journal",
      "publication_date": "2023-12-11",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10714284/",
      "pubmed_page": "https://pubmed.ncbi.nlm.nih.gov/38078870/",
      "claims": [
        {
          "claim": "Weight change weeks 36 to 88",
          "figure": "+14.0% after switch to placebo vs -5.5% continuing"
        }
      ]
    },
    {
      "citation": 50,
      "title": "Zepbound (tirzepatide) prescribing information",
      "publisher": "DailyMed, US National Library of Medicine",
      "type": "Drug label",
      "publication_date": "2026-09-02",
      "url": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b",
      "claims": [
        {
          "claim": "Heart rate",
          "figure": "+1 to 3 bpm"
        },
        {
          "claim": "OSA severity definitions",
          "figure": "Moderate AHI 15 to 30; severe 30 or more events per hour"
        }
      ]
    },
    {
      "citation": 51,
      "title": "Wegovy (semaglutide) prescribing information",
      "publisher": "DailyMed, US National Library of Medicine",
      "type": "Drug label",
      "publication_date": "2026-06-30",
      "url": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b",
      "claims": [
        {
          "claim": "Heart rate",
          "figure": "+1 to 4 bpm"
        },
        {
          "claim": "Discontinuation due to adverse reactions (pooled)",
          "figure": "6.8% vs 3.2%"
        }
      ]
    },
    {
      "citation": 52,
      "title": "Fact sheet: most-favored-nation pricing developments",
      "publisher": "The White House",
      "type": "Government",
      "publication_date": "2025-11-06",
      "url": "https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/",
      "claims": [
        {
          "claim": "Prior monthly list prices",
          "figure": "Wegovy $1,350; Zepbound $1,086"
        },
        {
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      "citation": 4,
      "claim": "TRIUMPH-3 weight change at 80 weeks, efficacy estimand (n=1,949)",
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    {
      "citation": 4,
      "claim": "TRIUMPH-3 adverse events",
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      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c-302832674.html",
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      "citation": 4,
      "claim": "TRIUMPH-3 discontinuation due to AEs",
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      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c-302832674.html",
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    {
      "citation": 4,
      "claim": "Regulatory plan",
      "figure": "Completing CMC package for a BLA; US submission planned Q1 2027",
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      "citation": 4,
      "claim": "Planned indications",
      "figure": "Obesity, knee osteoarthritis pain, obstructive sleep apnea",
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      "citation": 4,
      "claim": "Program size",
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    {
      "citation": 5,
      "claim": "TRIUMPH-4 weight change at 68 weeks, efficacy estimand (n=445)",
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      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html",
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      "citation": 5,
      "claim": "TRIUMPH-4 weight change, treatment-regimen estimand",
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    {
      "citation": 5,
      "claim": "WOMAC pain change from 6.0, efficacy estimand",
      "figure": "-4.5 (-75.8%) / -4.4 (-74.3%) vs -2.4 (-40.3%)",
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      "citation": 5,
      "claim": "WOMAC physical function change, efficacy estimand",
      "figure": "-4.1 / -4.2 vs -2.1",
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      "citation": 5,
      "claim": "Systolic blood pressure at 12 mg",
      "figure": "-14.0 mmHg",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html",
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    {
      "citation": 5,
      "claim": "Dysesthesia",
      "figure": "8.8% / 20.9% vs 0.7%",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html",
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    {
      "citation": 5,
      "claim": "GI adverse events",
      "figure": "nausea 38.1/43.2 vs 10.7; diarrhea 34.7/33.1 vs 13.4; constipation 21.8/25.0 vs 8.7; vomiting 20.4/20.9 vs 0.0 (%)",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html",
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    {
      "citation": 5,
      "claim": "Discontinuation due to AEs",
      "figure": "12.2% / 18.2% vs 4.0%; BMI 35+ subgroup 8.8/12.1 vs 4.8%",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-delivered-weight-loss-of-up-to-an-average-of-71-2-lbs-along-with-substantial-relief-from-osteoarthritis-pain-in-first-successful-phase-3-trial-302638804.html",
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    {
      "citation": 5,
      "claim": "Baseline",
      "figure": "84.0% BMI 35+; BMI 40.4",
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      "citation": 6,
      "claim": "HbA1c change from 7.9%, efficacy estimand",
      "figure": "-1.7 / -2.0 / -1.9 vs -0.8 points",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-demonstrated-significant-reductions-in-a1c-and-weight-in-first-phase-3-trial-for-treatment-of-type-2-diabetes-302718589.html",
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    {
      "citation": 6,
      "claim": "Weight change at 40 weeks, efficacy estimand",
      "figure": "-11.5% / -15.5% / -16.8% vs -2.5%",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-demonstrated-significant-reductions-in-a1c-and-weight-in-first-phase-3-trial-for-treatment-of-type-2-diabetes-302718589.html",
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    {
      "citation": 6,
      "claim": "GI adverse events",
      "figure": "nausea 16.4/19.5/26.5 vs 3.7; diarrhea 18.7/26.3/22.8 vs 4.5; vomiting 15.7/15.0/17.6 vs 2.2 (%)",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-demonstrated-significant-reductions-in-a1c-and-weight-in-first-phase-3-trial-for-treatment-of-type-2-diabetes-302718589.html",
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    {
      "citation": 6,
      "claim": "Discontinuation due to AEs",
      "figure": "2.2% / 4.5% / 5.1% vs 0.0%",
      "url": "https://www.prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-demonstrated-significant-reductions-in-a1c-and-weight-in-first-phase-3-trial-for-treatment-of-type-2-diabetes-302718589.html",
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    {
      "citation": 7,
      "claim": "Design",
      "figure": "n=537; 40 weeks; HbA1c 7.0 to 9.5%; BMI 23+; no glucose-lowering drugs for 90 days",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=42250575&rettype=abstract&retmode=text",
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    {
      "citation": 7,
      "claim": "Weight change, treatment-regimen estimand",
      "figure": "-11.5% / -13.9% / -15.3% vs -2.6%",
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    {
      "citation": 7,
      "claim": "HbA1c change, treatment-regimen estimand",
      "figure": "-1.69 / -1.86 / -1.94 vs -0.81",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=42250575&rettype=abstract&retmode=text",
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    {
      "citation": 8,
      "claim": "Participants reaching HbA1c under 7.0%",
      "figure": "84.0% / 88.9% / 90.4% vs 52.1%",
      "url": "https://www.lilly.com/hcp/congresses/ada-2026/dv-036761-rt",
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    {
      "citation": 8,
      "claim": "Participants reaching HbA1c under 5.7%",
      "figure": "36.6% / 45.7% / 39.0% vs 14.1%",
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    {
      "citation": 8,
      "claim": "Serious AEs",
      "figure": "4.5% / 0.8% / 3.7% vs 1.5%; no severe hypoglycemia",
      "url": "https://www.lilly.com/hcp/congresses/ada-2026/dv-036761-rt",
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    {
      "citation": 9,
      "claim": "Weight change at 48 weeks",
      "figure": "1 mg -8.7%; 4 mg -17.1%; 8 mg -22.8%; 12 mg -24.2%; placebo -2.1%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37366315&rettype=abstract&retmode=text",
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    {
      "citation": 9,
      "claim": "Weight change at 24 weeks",
      "figure": "-7.2% / -12.9% / -17.3% / -17.5% vs -1.6%",
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    {
      "citation": 9,
      "claim": "Reaching 5/10/15% loss at 48 weeks on 12 mg",
      "figure": "100% / 93% / 83% vs 27% / 9% / 2%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37366315&rettype=abstract&retmode=text",
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    {
      "citation": 10,
      "claim": "Receptor potency relative to native hormones",
      "figure": "GIP 8.9x; GLP-1 0.4x; glucagon 0.3x",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Half-life",
      "figure": "about 6 days",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Estimand used",
      "figure": "Efficacy estimand for reported results",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
      "publication_date": "2023-06-26"
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    {
      "citation": 10,
      "claim": "Eligibility",
      "figure": "Age 18 to 75; BMI 30 to 50, or 27 to under 30 with a weight-related condition; no diabetes",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Nausea by starting dose at 8 mg",
      "figure": "17% (2 mg start) vs 60% (4 mg start)",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "12 mg adverse events vs placebo",
      "figure": "nausea 45 vs 11; diarrhea 15 vs 11; vomiting 19 vs 1; constipation 16 vs 3 (%)",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
      "publication_date": "2023-06-26"
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    {
      "citation": 10,
      "claim": "Discontinuation due to AEs",
      "figure": "6% to 16% retatrutide (16% at 12 mg) vs 0% placebo",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Skin sensation events",
      "figure": "7% retatrutide vs 1% placebo; 13% at 12 mg",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Cardiac arrhythmia AEs",
      "figure": "11% at 12 mg vs 3% placebo",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Heart rate",
      "figure": "Dose-dependent increase peaking at 24 weeks, then declining",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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      "citation": 10,
      "claim": "LDL cholesterol",
      "figure": "about 20% reduction",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Antihypertensive medication stopped",
      "figure": "41% (8 mg) and 30% (12 mg)",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Prediabetes reverting to normoglycemia",
      "figure": "72% vs 22%",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Waist circumference",
      "figure": "-6.5 to -19.6 cm vs -2.6 cm",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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    {
      "citation": 10,
      "claim": "Serious adverse events",
      "figure": "4% in both groups",
      "url": "https://mediacenteratypon.nejmgroup-production.org/NEJMoa2301972.pdf",
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      "citation": 11,
      "claim": "Liver fat relative change at 48 weeks",
      "figure": "8 mg -81.7%; 12 mg -86.0%; placebo -4.6%",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11271400/",
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      "citation": 11,
      "claim": "Liver fat relative change at 24 weeks",
      "figure": "8 mg -81.4%; 12 mg -82.4%; placebo +0.3%",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11271400/",
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    {
      "citation": 11,
      "claim": "Normal liver fat (under 5%) at 48 weeks",
      "figure": "89% (8 mg) and 93% (12 mg)",
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    {
      "citation": 11,
      "claim": "Substudy size and completeness",
      "figure": "98 participants; week-48 MRI for 43.9%",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11271400/",
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      "citation": 11,
      "claim": "Visceral fat change at 48 weeks",
      "figure": "-16.1% to -48.3% vs +2.5%",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11271400/",
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      "citation": 12,
      "claim": "HbA1c change at 24 weeks",
      "figure": "up to -2.02 points (12 mg)",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37385280&rettype=abstract&retmode=text",
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    {
      "citation": 12,
      "claim": "Weight change at 36 weeks",
      "figure": "up to -16.94% (12 mg)",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37385280&rettype=abstract&retmode=text",
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      "citation": 12,
      "claim": "Size",
      "figure": "n=281",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37385280&rettype=abstract&retmode=text",
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      "citation": 13,
      "claim": "Total fat mass reduction at 36 weeks",
      "figure": "8 mg 26.1%; 12 mg 23.2%; placebo 4.5%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=40609566&rettype=abstract&retmode=text",
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    {
      "citation": 13,
      "claim": "Evaluable participants",
      "figure": "103 with baseline and week-36 DXA",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=40609566&rettype=abstract&retmode=text",
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      "citation": 13,
      "claim": "Lean mass share",
      "figure": "Proportion of lean mass lost similar to other obesity treatments (qualitative)",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=40609566&rettype=abstract&retmode=text",
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    {
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      "claim": "Mechanism",
      "figure": "Glucagon receptor activity increased energy expenditure in mice",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=35985340&rettype=abstract&retmode=text",
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    {
      "citation": 15,
      "claim": "Half-life",
      "figure": "about 6 days",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=36354040&rettype=abstract&retmode=text",
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    {
      "citation": 16,
      "claim": "Eligibility",
      "figure": "BMI 30+, or 27+ with hypertension, dyslipidemia, OSA or CVD; adults 18+; no diabetes",
      "url": "https://clinicaltrials.gov/study/NCT05929066",
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    {
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    {
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      "claim": "Actual enrollment",
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    {
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      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 2335 (actual); primary completion 2026-04-06 (actual); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT05929066",
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    {
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      "claim": "Eligibility",
      "figure": "BMI 27+; type 2 diabetes on stable treatment 90+ days",
      "url": "https://clinicaltrials.gov/study/NCT05929079",
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    {
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      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 1152 (actual); primary completion 2026-06-16 (actual); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT05929079",
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    {
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      "claim": "Eligibility",
      "figure": "BMI 35+ with prior MI, stroke or symptomatic PAD",
      "url": "https://clinicaltrials.gov/study/NCT05882045",
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    {
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      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 1946 (actual); primary completion 2026-04-16 (actual); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT05882045",
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    {
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      "claim": "Eligibility",
      "figure": "BMI 27+; knee OA with Kellgren-Lawrence grade 2 or 3; no diabetes",
      "url": "https://clinicaltrials.gov/study/NCT05931367",
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    {
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      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 445 (actual); primary completion 2025-11-14 (actual); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT05931367",
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    {
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      "claim": "Design",
      "figure": "Retatrutide vs tirzepatide; 80-week primary endpoint",
      "url": "https://clinicaltrials.gov/study/NCT06662383",
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    {
      "citation": 20,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 800 (estimated); primary completion 2026-11 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06662383",
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    {
      "citation": 21,
      "claim": "Design",
      "figure": "Adults 45+ with BMI 27+ and ASCVD or CKD; event-driven cardiovascular and kidney endpoints",
      "url": "https://clinicaltrials.gov/study/NCT06383390",
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    },
    {
      "citation": 21,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 10000 (estimated); primary completion 2029-02 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06383390",
      "publication_date": "2026-08-24"
    },
    {
      "citation": 22,
      "claim": "Design",
      "figure": "Chronic low back pain; pain and weight endpoints up to 72 weeks",
      "url": "https://clinicaltrials.gov/study/NCT07035093",
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    },
    {
      "citation": 22,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 586 (estimated); primary completion 2027-09 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT07035093",
      "publication_date": "2026-07-23"
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    {
      "citation": 23,
      "claim": "Design",
      "figure": "Retatrutide and tirzepatide arms vs placebo; major adverse liver outcomes endpoint",
      "url": "https://clinicaltrials.gov/study/NCT07165028",
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    {
      "citation": 23,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "RECRUITING; enrollment 4500 (estimated); primary completion 2030-08 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT07165028",
      "publication_date": "2026-09-22"
    },
    {
      "citation": 24,
      "claim": "Design",
      "figure": "80 weeks on dose 1, then 36 weeks on dose 1, dose 2 or placebo; 116-week endpoint",
      "url": "https://clinicaltrials.gov/study/NCT06859268",
      "publication_date": "2026-03-03"
    },
    {
      "citation": 24,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 643 (estimated); primary completion 2028-04 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06859268",
      "publication_date": "2026-03-03"
    },
    {
      "citation": 25,
      "claim": "Design",
      "figure": "Three escalation schemes; 104-week endpoint",
      "url": "https://clinicaltrials.gov/study/NCT07357415",
      "publication_date": "2026-06-09"
    },
    {
      "citation": 25,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 600 (estimated); primary completion 2028-10 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT07357415",
      "publication_date": "2026-06-09"
    },
    {
      "citation": 26,
      "claim": "Design",
      "figure": "Two doses vs placebo; 56-week endpoint",
      "url": "https://clinicaltrials.gov/study/NCT07232719",
      "publication_date": "2026-04-17"
    },
    {
      "citation": 26,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 250 (estimated); primary completion 2027-07 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT07232719",
      "publication_date": "2026-04-17"
    },
    {
      "citation": 27,
      "claim": "Criteria",
      "figure": "Adults with BMI 35+ despite highest available dose of chronic weight management therapy and 2+ serious obesity complications; unable to join a trial",
      "url": "https://clinicaltrials.gov/study/NCT07629401",
      "publication_date": "2026-08-06"
    },
    {
      "citation": 27,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "AVAILABLE; enrollment n/a (n/a); primary completion n/a (n/a); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT07629401",
      "publication_date": "2026-08-06"
    },
    {
      "citation": 28,
      "claim": "Eligibility",
      "figure": "HbA1c 7.0% to 9.5%; BMI 23+; no glucose-lowering drugs for 90 days",
      "url": "https://clinicaltrials.gov/study/NCT06354660",
      "publication_date": "2026-03-05"
    },
    {
      "citation": 28,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 537 (actual); primary completion 2026-01-22 (actual); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06354660",
      "publication_date": "2026-03-05"
    },
    {
      "citation": 29,
      "claim": "Design",
      "figure": "Participants on metformin; open-label vs semaglutide; 80-week HbA1c endpoint",
      "url": "https://clinicaltrials.gov/study/NCT06260722",
      "publication_date": "2026-04-13"
    },
    {
      "citation": 29,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 1250 (estimated); primary completion 2026-08 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06260722",
      "publication_date": "2026-04-13"
    },
    {
      "citation": 30,
      "claim": "Design",
      "figure": "Participants on basal insulin with renal impairment; 52-week HbA1c endpoint",
      "url": "https://clinicaltrials.gov/study/NCT06297603",
      "publication_date": "2026-07-20"
    },
    {
      "citation": 30,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "ACTIVE_NOT_RECRUITING; enrollment 320 (estimated); primary completion 2026-10 (estimated); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06297603",
      "publication_date": "2026-07-20"
    },
    {
      "citation": 31,
      "claim": "Submission timing and classification dispute",
      "figure": "Q1 2027 BLA plan restated; classification described as active litigation",
      "url": "https://www.theglobeandmail.com/investing/markets/stocks/LLY-N/pressreleases/3818844/eli-lilly-lly-q2-2026-earnings-call-transcript/",
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    {
      "citation": 32,
      "claim": "Submission timing",
      "figure": "Retatrutide submissions for obesity, OSA and knee OA now expected 2027",
      "url": "https://investor.lilly.com/static-files/ab69001c-650b-44f6-b629-309ee33f2335",
      "publication_date": "2026-08-05"
    },
    {
      "citation": 33,
      "claim": "Classification dispute",
      "figure": "FDA determined retatrutide is not a biological product; court vacated and remanded; Lilly appealed",
      "url": "https://www.biospace.com/fda/lilly-fda-retatrutide-biologic-dispute-comes-to-a-head-as-submission-nears",
      "publication_date": "2026-08-05"
    },
    {
      "citation": 33,
      "claim": "Exclusivity at stake",
      "figure": "BLA confers 12 years of market exclusivity",
      "url": "https://www.biospace.com/fda/lilly-fda-retatrutide-biologic-dispute-comes-to-a-head-as-submission-nears",
      "publication_date": "2026-08-05"
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    {
      "citation": 34,
      "claim": "Appeal schedule",
      "figure": "Seventh Circuit oral argument 24 Sep 2026 (not checked against the court docket)",
      "url": "https://reason.com/2026/09/10/can-a-new-weight-loss-treatment-escape-the-legal-and-regulatory-thicket/",
      "publication_date": "2026-09-10"
    },
    {
      "citation": 35,
      "claim": "Approval status",
      "figure": "Not approved for human use by any regulatory agency in the world",
      "url": "https://investor.lilly.com/news-releases/news-release-details/lilly-calls-online-platforms-payment-companies-and-regulators",
      "publication_date": "2026-08-12"
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    {
      "citation": 35,
      "claim": "Enforcement",
      "figure": "6 lawsuits filed against sellers",
      "url": "https://investor.lilly.com/news-releases/news-release-details/lilly-calls-online-platforms-payment-companies-and-regulators",
      "publication_date": "2026-08-12"
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    {
      "citation": 36,
      "claim": "EASD symposium",
      "figure": "30 Sep 2026, Milan; TRIUMPH-2 featured",
      "url": "https://www.prnewswire.com/news-releases/lilly-to-present-new-data-on-foundayo-retatrutide-and-eloratzp-at-easd-2026-as-it-strives-to-change-the-course-of-cardiometabolic-health-302878341.html",
      "publication_date": "2026-09-15"
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    {
      "citation": 37,
      "claim": "Compounding",
      "figure": "Retatrutide cannot be used in compounding under federal law",
      "url": "https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss",
      "publication_date": "2026-09-01"
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    {
      "citation": 38,
      "claim": "Why retatrutide cannot be compounded",
      "figure": "Not eligible under section 503A or 503B",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/glp-1-solution-715883-09092025",
      "publication_date": "2025-09-09"
    },
    {
      "citation": 39,
      "claim": "Research-use-only retatrutide sales",
      "figure": "Warning letter dated 24 Aug 2026",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/peptide-partners-llc-735063-08242026",
      "publication_date": "2026-08-24"
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    {
      "citation": 40,
      "claim": "Status",
      "figure": "Retatrutide products are unapproved new drugs",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/royal-peptides-llc-734884-08242026",
      "publication_date": "2026-08-24"
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    {
      "citation": 41,
      "claim": "Quality of illegally sold GLP-1 product",
      "figure": "Purity 7.7% to 14.37%; endotoxin in all samples; 3 vials tested",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11582493/",
      "publication_date": "2024-11-07"
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    {
      "citation": 42,
      "claim": "Shortages resolved",
      "figure": "Tirzepatide 19 Dec 2024; semaglutide 21 Feb 2025",
      "url": "https://www.fda.gov/drugs/drug-alerts-and-statements/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize",
      "publication_date": "2026-04-01"
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    {
      "citation": 43,
      "claim": "Weight change at 72 weeks, treatment-regimen estimand",
      "figure": "-15.0% / -19.5% / -20.9% vs -3.1%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=35658024&rettype=abstract&retmode=text",
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    },
    {
      "citation": 43,
      "claim": "Discontinuation due to AEs",
      "figure": "4.3% / 7.1% / 6.2% vs 2.6%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=35658024&rettype=abstract&retmode=text",
      "publication_date": "2022-06-04"
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    {
      "citation": 44,
      "claim": "Efficacy estimand weight change",
      "figure": "-16.0% / -21.4% / -22.5% vs -2.4%",
      "url": "https://investor.lilly.com/news-releases/news-release-details/lillys-surmount-1-results-published-new-england-journal-medicine",
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    {
      "citation": 44,
      "claim": "GI adverse events at 15 mg vs placebo",
      "figure": "nausea 31.0 vs 9.5; diarrhea 23.0 vs 7.3; vomiting 12.2 vs 1.7; constipation 11.7 vs 5.8 (%)",
      "url": "https://investor.lilly.com/news-releases/news-release-details/lillys-surmount-1-results-published-new-england-journal-medicine",
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    {
      "citation": 45,
      "claim": "Weight change at 68 weeks",
      "figure": "-14.9% vs -2.4%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=33567185&rettype=abstract&retmode=text",
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    {
      "citation": 45,
      "claim": "Discontinuation due to GI events",
      "figure": "4.5% vs 0.8%",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=33567185&rettype=abstract&retmode=text",
      "publication_date": "2021-02-10"
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    {
      "citation": 46,
      "claim": "GI adverse events",
      "figure": "nausea 44.1 vs 17.4; diarrhea 31.5 vs 15.9; vomiting 24.6 vs 6.6; constipation 23.4 vs 9.5 (%)",
      "url": "https://clinicaltrials.gov/study/NCT03548935",
      "publication_date": "2026-09-23"
    },
    {
      "citation": 47,
      "claim": "Weight change at 72 weeks",
      "figure": "-20.2% (tirzepatide) vs -13.7% (semaglutide)",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=40353578&rettype=abstract&retmode=text",
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    {
      "citation": 48,
      "claim": "Regain one year after stopping",
      "figure": "11.6 of 17.3 percentage points regained",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/",
      "publication_date": "2022-05-19"
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    {
      "citation": 49,
      "claim": "Weight change weeks 36 to 88",
      "figure": "+14.0% after switch to placebo vs -5.5% continuing",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10714284/",
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    {
      "citation": 50,
      "claim": "Heart rate",
      "figure": "+1 to 3 bpm",
      "url": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b",
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    {
      "citation": 50,
      "claim": "OSA severity definitions",
      "figure": "Moderate AHI 15 to 30; severe 30 or more events per hour",
      "url": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b",
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    {
      "citation": 51,
      "claim": "Heart rate",
      "figure": "+1 to 4 bpm",
      "url": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b",
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    {
      "citation": 51,
      "claim": "Discontinuation due to adverse reactions (pooled)",
      "figure": "6.8% vs 3.2%",
      "url": "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b",
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    {
      "citation": 52,
      "claim": "Prior monthly list prices",
      "figure": "Wegovy $1,350; Zepbound $1,086",
      "url": "https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/",
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    {
      "citation": 52,
      "claim": "Announced prices",
      "figure": "Medicare $245; Medicare copay $50; TrumpRx $350 (semaglutide), average $346 (Zepbound and orforglipron)",
      "url": "https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/",
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    {
      "citation": 53,
      "claim": "Self-pay prices",
      "figure": "$299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg if refilled within 45 days); otherwise $499 to $699",
      "url": "https://www.lilly.com/lillydirect/zepbound",
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    {
      "citation": 54,
      "claim": "Self-pay price",
      "figure": "$349 per month for injection doses 0.25 to 2.4 mg",
      "url": "https://www.novocare.com/pharmacy/wegovy/offer.html",
      "publication_date": "2026-09-23"
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    {
      "citation": 55,
      "claim": "New list price",
      "figure": "$675 per month from 1 Jan 2027",
      "url": "https://www.prnewswire.com/news-releases/novo-nordisk-announces-significant-reduction-in-us-list-price-for-wegovy-ozempic-and-rybelsus-semaglutide-medicines-building-on-continued-efforts-to-expand-access-302695705.html",
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    {
      "citation": 56,
      "claim": "Self-pay price",
      "figure": "from $149 per month at the lowest dose",
      "url": "https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-foundayotm-orforglipron-only-glp-1-pill",
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    {
      "citation": 57,
      "claim": "Glucagon and energy expenditure",
      "figure": "Glucagon infusion in fasted humans raised energy expenditure about 230 kcal/day; most mechanistic data from rodents",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12910462/",
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    {
      "citation": 58,
      "claim": "Estimand definition",
      "figure": "Precise description of the treatment effect, including handling of intercurrent events",
      "url": "https://www.fda.gov/media/148473/download",
      "publication_date": "2021-05-01"
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    {
      "citation": 59,
      "claim": "MASLD definition",
      "figure": "Steatosis plus at least 1 of 5 cardiometabolic risk factors",
      "url": "https://eutils.ncbi.nlm.nih.gov/entrez/eutils/efetch.fcgi?db=pubmed&id=37364790&rettype=abstract&retmode=text",
      "publication_date": "2023-06-24"
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    {
      "citation": 60,
      "claim": "Review goals for new molecular entity NDAs and original BLAs",
      "figure": "Standard: 10 months after the 60-day filing date; priority: 6 months after the 60-day filing date",
      "url": "https://www.fda.gov/media/151712/download",
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    {
      "citation": 61,
      "claim": "Protein threshold",
      "figure": "A protein has more than 40 amino acids; shorter peptides are regulated as drugs",
      "url": "https://www.fda.gov/about-fda/economic-impact-analyses-fda-regulations/definition-term-biological-product-final-regulatory-impact-analysis",
      "publication_date": "2020-02-21"
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    {
      "citation": 62,
      "claim": "Research-use-only retatrutide sales",
      "figure": "Warning letter dated 31 Mar 2026",
      "url": "https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/gram-peptides-721806-03312026",
      "publication_date": "2026-03-31"
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    {
      "citation": 63,
      "claim": "Design",
      "figure": "Calorie intake and energy expenditure on retatrutide vs placebo",
      "url": "https://clinicaltrials.gov/study/NCT06313528",
      "publication_date": "2025-09-23"
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    {
      "citation": 63,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 85 (actual); primary completion 2025-08-26 (actual); results posted: no",
      "url": "https://clinicaltrials.gov/study/NCT06313528",
      "publication_date": "2025-09-23"
    },
    {
      "citation": 64,
      "claim": "Qualifying conditions for BMI 27 to under 30",
      "figure": "Hypertension, dyslipidemia or cardiovascular disease",
      "url": "https://clinicaltrials.gov/study/NCT04881760",
      "publication_date": "2023-09-13"
    },
    {
      "citation": 64,
      "claim": "Registry status (auto-synced 2026-09-23)",
      "figure": "COMPLETED; enrollment 338 (actual); primary completion 2022-05-16 (actual); results posted: yes",
      "url": "https://clinicaltrials.gov/study/NCT04881760",
      "publication_date": "2023-09-13"
    },
    {
      "citation": 65,
      "claim": "Review target",
      "figure": "1 to 2 months target vs 6+ months for other priority programs",
      "url": "https://www.fda.gov/industry/commissioners-national-priority-voucher-cnpv-pilot-program",
      "publication_date": "2026-08-26"
    }
  ],
  "unverified": [
    {
      "item": "Retatrutide heart-rate increase in beats per minute",
      "reason": "Magnitude only in NEJM supplement; not in accessible primary text; not reported for Phase 3"
    },
    {
      "item": "Exact lean-mass percentage in DXA substudy",
      "reason": "Full text paywalled; abstract qualitative only"
    },
    {
      "item": "\"No plateau\" at 104 weeks in TRIUMPH-1",
      "reason": "Not stated in Lilly TRIUMPH-1 materials"
    },
    {
      "item": "Seventh Circuit oral argument on 24 Sep 2026",
      "reason": "Single secondary source (Reason); court docket not checked"
    }
  ]
}