Real-world evidence is what tells you whether a Phase 3 result holds up in routine care. Coverage on this site has leaned on Truveta's EHR network, IQVIA, and several academic registry analyses — particularly for GLP-1 outcomes outside trial conditions.
Key reads: the Truveta EHR analysis at OMA 2026 reproducing SURMOUNT-5's tirzepatide-vs-semaglutide signal at 12 months in routine care; the Mass General Brigham JAMA study of 90,000+ HFpEF patients on semaglutide and tirzepatide; the AAN 2026 living systematic review of GLP-1 dementia incidence in 2+ million diabetics; and the Foundayo IQVIA launch tracker through retail pharmacy.
Stories here cover the registry analyses, the Truveta and IQVIA data drops, and the policy implications. See #clinical-trial for trial-side coverage.
A Frontiers in Endocrinology multicenter retrospective cohort study (2026) reports real-world safety and effectiveness of semaglutide in patients with type 2 diabetes and end-stage renal disease — the population systematically excluded from FLOW (which capped at eGFR ≥ 25) and the SELECT pre-specified kidney composite analysis. ESRD patients comprise roughly 1% of the diabetic population but 7% of US healthcare spending; their cardiovascular event rates are among the highest documented. The cohort fills a clinical gap: prescribers managing dialysis-dependent patients have had to extrapolate from outcome trials that explicitly excluded the population. Work joins the SOUL oral-semaglutide CKD analysis as the fastest-growing GLP-1 evidence stream beyond obesity and T2D.
A presentation at the American Academy of Neurology 2026 meeting (closing April 22) reported that in 10,997 chronic migraine patients initiating GLP-1 agonists versus an equal topiramate cohort, GLP-1 users were 10% less likely to visit the ED (23.7% vs 26.4%), 14% less likely to be hospitalized, 42% less likely to start CGRP monoclonal antibodies, and 48% less likely to start valproate over 12 months — adding migraine to the growing list of GLP-1 secondary benefits.
A living systematic review presented at the American Academy of Neurology 2026 Annual Meeting integrating Phase 2/3 trials and real-world data from 2+ million individuals with diabetes found GLP-1 receptor agonist use was associated with a 20-35% lower incidence of dementia versus DPP-4 or SGLT2 inhibitors. Effect was strongest for semaglutide, despite the EVOKE Phase 3 Alzheimer's trial missing its cognitive endpoint.
A poster at the Obesity Medical Association annual conference (April 10-12, San Diego) showed tirzepatide achieved greater body weight reduction than semaglutide at 12 months in a real-world Truveta EHR analysis of adults with obesity without diabetes, consistent with SURMOUNT-5 clinical trial results.
Researchers analyzed 410,198 Reddit posts mentioning semaglutide or tirzepatide, finding 43.5% of 67,008 self-reported users described at least one side effect extending beyond clinical trial data.