Introduction: Pharmacological therapies are recommended for individuals with obesity. Semaglutide, a glucagon‐like peptide‐1 receptor agonist (GLP‐1), and tirzepatide, a dual glucose‐dependent insulinotropic polypeptide and GLP‐1 receptor agonist (GIP/GLP‐1), are among the leading pharmacological options for obesity treatment. This network meta‐analysis (NMA) aims to evaluate the comparative efficacy of these two agents in reducing body weight and improving glycemic parameters. Methods: Pairwise comparisons within the NMA were conducted using a frequentist approach in RCTs comparing tirzepatide or semaglutide versus placebo, as well as tirzepatide versus semaglutide at their maximum dosages (15 and 2.4 mg, respectively). Results: A total of 28 RCTs were included, comprising 34 367 participants, 39.6% of whom were women and with a mean age of 57.8 ± 8.95 years. Tirzepatide demonstrated superiority over semaglutide in percentage weight reduction (mean difference [MD] 6.10%; 95% CI: 3.64, 8.57), absolute weight loss (MD 4.55 kg; 95% CI: 1.28, 7.83), BMI reduction (MD 1.71 kg/m ² ; 95% CI: 0.08, 3.34), and waist circumference reduction (MD 2.89 cm; 95% CI: 1.25, 4.53). Regarding glycemic parameters, tirzepatide was also more effective than semaglutide in reducing HbA1c (MD 0.33%; 95% CI: 0.20, 0.46) and fasting blood glucose (MD 10.39 mg/dL; 95% CI: 4.48, 16.29). Conclusion: In this NMA, tirzepatide appeared to be superior to semaglutide in both body weight reduction and improvement of glycemic indices.

Burn injuries often require surgery, posing challenges due to significant intraoperative blood loss and transfusion risks. Tranexamic Acid (TXA), an antifibrinolytic agent, stabilizes clots and reduces fibrinolysis, with proven efficacy in various surgical settings. However, the benefits in burn patients are yet to be established. We performed a systematic review and meta-analysis. PubMed, Embase, and Cochrane databases were searched for Randomized Clinical Trials (RCTs) comparing TXA versus control in burned patients. Risk Ratios (RR) and Mean Differences (MD) with 95% CIs were computed for binary and continuous outcomes, respectively. The primary endpoint of interest was blood loss. Statistical analyses were performed using RStudio software (version 4.2.2). The certainty of the evidence was evaluated using the GRADE approach. Four RCTs comprising 204 patients were included, with 102 (50%) assigned to the TXA group. The mean patient age across studies ranged from 32.15 to 39.70 years. TXA significantly reduced total blood loss (MD = -183.93 mL; 95% CI: -278.44 to -89.42; p < 0.01), need for packed red blood cell transfusions (RR = 0.42, 95% CI 0.26 to 0.66; p < 0.01), while also improving hematocrit (MD = 3.49%; 95% CI: 1.58 to 5.41; p < 0.01) and hemoglobin levels (MD = 0.87 g.dL^-1; 95% CI: 0.35 to 1.39; p < 0.01). In patients with burns, TXA was associated with reduced blood loss and packed cell transfusions. However, certainty is limited by the small number and heterogeneity of available trials REGISTRATION: PROSPERO ID: CRD420251000356. Registered on 07 March 2025.