GLP-1 receptor agonist therapy spans multiple indications. These pages explain the evidence base, FDA-approved labeling, and practical clinical considerations for each.
Type 2 diabetes
The original GLP-1 indication. SUSTAIN, SURPASS, REWIND trial programs.
Obesity
STEP-1 (sema 14.9%), SURMOUNT-1 (tirz 20.9%). Chronic disease framing.
Cardiovascular disease
SELECT — 20% MACE reduction. Wegovy CV indication (March 2024).
Sleep apnea (OSA)
SURMOUNT-OSA — ~30 events/hr AHI reduction. Zepbound first OSA drug.
Fatty liver / MASH
Wegovy FDA-approved for MASH (2025) after ESSENCE: 62.9% vs 34.3% resolution. SYNERGY-NASH (tirz, phase 2).
Chronic kidney disease
FLOW — 24% reduction in major kidney events in T2D + CKD.
PCOS
Mechanism aligns with PCOS pathophysiology. Fertility implications.
Prediabetes
Off-label but well-supported by mechanism and weight-loss benefit.
Metabolic syndrome
Multi-component improvement: weight, glycemia, BP, lipids.