GLPwatch
Injection-site and dermatologic reactions associated with glucagon-like peptide-1 receptor agonists: Insights from meta-analysis of randomised controlled trials and real-world evidence.
Diabetes Obes Metab · 2026
Last updated 2026-05-28A review of 14 clinical trials involving 4,861 patients found that people taking GLP-1 drugs were 3.55 times more likely to experience injection-site reactions like redness or pain compared to those not taking these medications. The study also noted that reactions were especially common with two specific drugs, exenatide and dulaglutide, which showed higher-than-expected reports of bleeding at the injection site in a separate database analysis.
AI summary of the abstract below.
| Journal | Diabetes Obes Metab, 2026 |
|---|---|
| Citations | 3 |
| Molecules | — |
Abstract
AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for type 2 diabetes mellitus and obesity, with once-weekly dosing that supports adherence. However, injection-site reactions (ISRs) and dermatologic events have been recognised, ranging from mild local events to rare systemic hypersensitivity reactions that may cause discontinuation. To evaluate dermatologic and ISR safety of GLP-1 RAs through a meta-analysis of randomised controlled trials (RCTs) and disproportionality analysis of data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS).
MATERIALS AND METHODS: PubMed, Embase and Web of Science were searched through December 2024 to identify RCTs reporting ISR or dermatologic outcomes for GLP-1 RAs. Random-effects meta-analysis synthesised trial evidence. A retrospective disproportionality analysis of FAERS data evaluated all approved GLP-1 RAs. Lower bound reporting odds ratios (LB ROR), proportional reporting ratios (PRR) and information components (IC) were calculated.
RESULTS: The pooled meta-analysis of 14 RCTs that reported ISRs (4861 patients; 396 ISR events) showed increased ISR risk with GLP-1 RAs versus comparators (risk ratio 3.55; 95% confidence interval, 2.35-5.36; I = 41.4%). Dermatologic events were infrequent and not significantly elevated. FAERS data analysis revealed potential ISR signals for exenatide and dulaglutide. Exenatide was associated with injection-site haemorrhage (PRR: 27.6; LB ROR: 29.4; IC: 4.6). Dulaglutide showed disproportionate reporting for injection-site haemorrhage (PRR: 11.5; LB ROR: 11.5; IC: 3.4).
CONCLUSIONS: GLP-1 RAs are consistently linked to higher ISR risk, especially with exenatide and dulaglutide, while generalised dermatologic events are rare. Clinicians should counsel patients about ISR risk to support adherence and optimise outcomes.
Verbatim abstract via PubMed 41395692 ↗