# Adverse events associated with tirzepatide: a focus on subgroup-specific differences

**Authors:** Zhongming Yu, Yiming Qi, Qian Gan, Guodong Wu, Xinhao Zhang, Cheng Jiang, Jing Li

PMC · DOI: 10.1186/s40360-026-01105-3 · BMC Pharmacology & Toxicology · 2026-02-26

## TL;DR

This study finds that tirzepatide's adverse events vary by subgroup, with males and diabetic patients more likely to report gastrointestinal issues.

## Contribution

The study identifies subgroup-specific differences in adverse events for tirzepatide using FAERS and JADER databases.

## Key findings

- Males were significantly more inclined to report gastrointestinal disorders.
- Diabetic patients showed higher frequency of gastrointestinal disorders compared to those using tirzepatide for weight control.

## Abstract

Tirzepatide is anticipated to play a pivotal role in managing overweight/obesity and/or type 2 diabetes. Although prior studies have employed spontaneous reporting databases for large-scale safety monitoring of tirzepatide focusing on novel adverse events, current understanding of potential disparities of the adverse events among subgroups remains unexplored.

This study aimed to evaluate the differences of adverse events across subgroups related to tirzepatide.

Using the data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) and Japanese Adverse Drug Event Report (JADER) databases, the differences in adverse events across specific subgroups concerning reporter type, sex, age, dose, indication, report year, onset time, and outcome were investigated using the ROR algorithm and Chi-Square Test/Fisher’s exact test. To further verify the differences, subgroup-based stratified analyses and sensitivity analyses were conducted.

The results showed that the adverse events related to tirzepatide showed significant difference across subgroups. Notably, males were significantly more inclined to report “gastrointestinal disorders”. Within indication-based subgroups, tirzepatide used in patients with diabetes mellitus was significantly more frequently associated with “gastrointestinal disorders” compared with patients in weight control purpose.

This study provides contribution for identification potential difference across subgroups, which can guide future research and more targeted monitoring strategies for tirzepatide in clinical practice. Further studies are required to validate these observations.

Not applicable.

The online version contains supplementary material available at 10.1186/s40360-026-01105-3.

Sex differences: Males more inclined to gastrointestinal disorders.

Indication differences: Diabetic patients more inclined to gastrointestinal disorders (vs. weight control).

The online version contains supplementary material available at 10.1186/s40360-026-01105-3.

## Linked entities

- **Chemicals:** tirzepatide (PubChem CID 163285897)
- **Diseases:** type 2 diabetes (MONDO:0005148), diabetes mellitus (MONDO:0005015)

## Full-text entities

- **Genes:** UBXN11 (UBX domain protein 11) [NCBI Gene 91544] {aka COA-1, PP2243, SOC, SOCI, UBXD5}, GLP1R (glucagon like peptide 1 receptor) [NCBI Gene 2740] {aka GLP-1, GLP-1-R, GLP-1R}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, GIP (gastric inhibitory polypeptide) [NCBI Gene 2695], GCG (glucagon) [NCBI Gene 2641] {aka GLP-1, GLP1, GLP2, GRPP}, HRH1 (histamine receptor H1) [NCBI Gene 3269] {aka H1-R, H1R, HH1R, hisH1}, TRPV1 (transient receptor potential cation channel subfamily V member 1) [NCBI Gene 7442] {aka VR1}, LINC-ROR (long intergenic non-protein coding RNA, regulator of reprogramming) [NCBI Gene 100885779] {aka ROR, lincRNA-RoR, lincRNA-ST8SIA3}
- **Diseases:** gastroparesis (MESH:D018589), acute kidney injury (MESH:D058186), site (MESH:D009371), Dehydration (MESH:D003681), Metabolism (MESH:D008659), overweight (MESH:D050177), Crohn's disease (MESH:D003424), weight (MESH:D015431), injection site pain (MESH:D000075662), impaired gastric emptying (MESH:D013272), ulcerative colitis (MESH:D003093), fibrosis (MESH:D005355), poisoning (MESH:D011041), chronic diarrhea (MESH:D003967), hyperglycemia (MESH:D006943), liver and gastrointestinal maladies (MESH:D017093), COVID-19 (MESH:D000086382), liver cirrhosis (MESH:D008103), MGPS (MESH:D005547), Hepatobiliary disorders (MESH:D004066), nutrition disorders (MESH:D009748), systemic disease (MESH:D034721), control (MESH:C536209), chronic inflammation (MESH:D007249), congenital anomaly (MESH:D000013), vomiting (MESH:D014839), hypoglycemia (MESH:D007003), inflammatory bowel disease (MESH:D015212), pruritus (MESH:D011537), acidosis (MESH:D000138), gastroesophageal reflux disease (MESH:D005764), haemorrhage (MESH:D006470), cholecystitis (MESH:D002764), Nausea (MESH:D009325), injury (MESH:D014947), Metabolism and nutrition disorders (MESH:D009750), constipation (MESH:D003248), PT (MESH:D000088562), obese (MESH:D009765), T2D (MESH:D003924), nonalcoholic fatty liver disease (MESH:D065626), Depression Syndrome (MESH:D003866), Death (MESH:D003643), acute pancreatitis (MESH:D010195), rash (MESH:D005076), cholangitis acute (MESH:D000208), Gastrointestinal adverse events (MESH:D002318), biliary colic (MESH:D003085), pain (MESH:D010146), gastric ulcer (MESH:D013276), hyperglycemic (MESH:D006944), cholelithiasis (MESH:D002769), Diabetes (MESH:D003920), Gastrointestinal disorders (MESH:D005767), irritable bowel syndrome (MESH:D043183), diverticular disease (MESH:D000076385), gallbladder or biliary diseases (MESH:D005705), acute gastritis (MESH:D005756)
- **Chemicals:** serotonin (MESH:D012701), glimepiride (MESH:C057619), histamine (MESH:D006632), blood glucose (MESH:D001786), amino acid (MESH:D000596), Metformin (MESH:D008687), pioglitazone (MESH:D000077205), glucose (MESH:D005947), glipizide (MESH:D005913), acarbose (MESH:D020909), lixisenatide (MESH:C479460), FAERS (-), saxagliptin (MESH:C502994), alcohol (MESH:D000438), exenatide (MESH:D000077270), lipid (MESH:D008055)
- **Species:** gut metagenome (species) [taxon 749906], Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

1 references — full list in the complete paper: https://tomesphere.com/paper/PMC13041219/full.md

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Source: https://tomesphere.com/paper/PMC13041219