{
  "records": [
    {"pmid": "39000001", "year": 2024, "drug": "semaglutide", "organ": "cardiovascular", "title": "Semaglutide reduces MACE in T2DM with established CVD", "abstract": "Semaglutide demonstrated significant reduction in major adverse cardiovascular events. Mechanism involves anti-inflammatory effect on endothelium.", "mechanism": "anti-inflammatory endothelial", "population": "T2DM with CVD"},
    {"pmid": "39000002", "year": 2024, "drug": "tirzepatide", "organ": "hepatic", "title": "Tirzepatide and MASLD resolution in obese non-diabetic adults", "abstract": "Tirzepatide showed hepatic steatosis reduction independent of weight loss via direct hepatocyte AMPK activation.", "mechanism": "AMPK activation hepatocyte", "population": "obese non-diabetic"},
    {"pmid": "39000003", "year": 2023, "drug": "liraglutide", "organ": "neurologic_central", "title": "Liraglutide neuroprotection in early Alzheimer disease pilot", "abstract": "Liraglutide modestly preserved hippocampal volume. Proposed mechanism: GLP-1R on astrocytes reducing neuroinflammation.", "mechanism": "astrocyte GLP-1R neuroinflammation", "population": "early AD"},
    {"pmid": "39000004", "year": 2024, "drug": "semaglutide", "organ": "behavioral_addiction", "title": "Semaglutide reduces alcohol craving in obese cohort", "abstract": "Retrospective FAERS-adjacent analysis shows lower alcohol use disorder rates. Hypothesized mesolimbic GLP-1R modulation.", "mechanism": "mesolimbic dopamine reward modulation", "population": "obese AUD"},
    {"pmid": "39000005", "year": 2023, "drug": "dulaglutide", "organ": "renal", "title": "Dulaglutide renal outcomes in REWIND post-hoc", "abstract": "Albuminuria reduction observed. Mechanism likely tubular natriuresis and hemodynamic effects.", "mechanism": "tubular natriuresis", "population": "T2DM CKD"},
    {"pmid": "39000006", "year": 2024, "drug": "tirzepatide", "organ": "sleep", "title": "Tirzepatide and obstructive sleep apnea AHI reduction (SURMOUNT-OSA)", "abstract": "Significant AHI reduction beyond weight loss alone. Adipose-tongue and upper airway mechanisms hypothesized.", "mechanism": "upper airway adipose reduction", "population": "obese OSA"},
    {"pmid": "39000007", "year": 2024, "drug": "semaglutide", "organ": "psychiatric", "title": "Semaglutide and depressive symptom changes in obese trial subgroup", "abstract": "Mixed effects observed; some mood improvement, some suicidal ideation reports. Central GLP-1R pathways implicated.", "mechanism": "central GLP-1R limbic", "population": "obese with mood sx"},
    {"pmid": "39000008", "year": 2023, "drug": "exenatide", "organ": "neurologic_central", "title": "Exenatide in Parkinson disease motor scores Exenatide-PD3", "abstract": "Phase 3 trial recently failed primary endpoint despite earlier signals. Substantia nigra GLP-1R hypothesis revisited.", "mechanism": "nigral GLP-1R neuroprotection", "population": "PD"},
    {"pmid": "39000009", "year": 2024, "drug": "semaglutide", "organ": "musculoskeletal", "title": "Semaglutide and lean mass loss concern in older adults", "abstract": "Concern for sarcopenia with significant lean mass loss in elderly. Direct myocyte effects unclear.", "mechanism": "skeletal muscle protein catabolism", "population": "elderly obese"},
    {"pmid": "39000010", "year": 2024, "drug": "tirzepatide", "organ": "musculoskeletal", "title": "Tirzepatide preserves lean mass better than semaglutide in head-to-head", "abstract": "GIP component may preserve muscle. GIPR on adipocytes vs myocytes differential effects.", "mechanism": "GIPR muscle preservation", "population": "obese non-elderly"},
    {"pmid": "39000011", "year": 2023, "drug": "liraglutide", "organ": "biliary", "title": "Liraglutide and gallstone formation risk meta-analysis", "abstract": "Increased cholelithiasis incidence. Bile composition and gallbladder motility implicated.", "mechanism": "gallbladder motility cholesterol supersaturation", "population": "obese T2DM"},
    {"pmid": "39000012", "year": 2024, "drug": "semaglutide", "organ": "ocular", "title": "Semaglutide early worsening of diabetic retinopathy in SUSTAIN-6", "abstract": "Early DR worsening signal. Possibly rapid glycemic correction or VEGF-mediated. Retinal GLP-1R unknown role.", "mechanism": "rapid glycemic shift VEGF", "population": "T2DM retinopathy"},
    {"pmid": "39000013", "year": 2024, "drug": "tirzepatide", "organ": "reproductive_female", "title": "Tirzepatide and ovulation restoration in PCOS pilot", "abstract": "Weight-loss-associated ovulation restoration. Direct ovarian GLP-1R role hypothesized but unproven.", "mechanism": "ovarian GLP-1R weight loss", "population": "PCOS obese"},
    {"pmid": "39000014", "year": 2023, "drug": "dulaglutide", "organ": "endocrine_thyroid", "title": "Dulaglutide thyroid C-cell tumor signal in rodents", "abstract": "Rodent C-cell hyperplasia known. Human MTC signal unclear. Calcitonin monitoring controversial.", "mechanism": "C-cell GLP-1R proliferation", "population": "rodent / human surveillance"},
    {"pmid": "39000015", "year": 2024, "drug": "semaglutide", "organ": "immunologic", "title": "Semaglutide modulates systemic inflammation markers", "abstract": "CRP and IL-6 reduction beyond weight loss. Macrophage polarization shift toward M2.", "mechanism": "macrophage M1 to M2 polarization", "population": "obese metabolic syndrome"},
    {"pmid": "39000016", "year": 2024, "drug": "tirzepatide", "organ": "adipose", "title": "Tirzepatide brown adipose activation FDG-PET pilot", "abstract": "Increased BAT FDG uptake. GIP component on adipocytes proposed.", "mechanism": "BAT thermogenesis GIPR", "population": "obese non-DM"},
    {"pmid": "39000017", "year": 2023, "drug": "semaglutide", "organ": "microbiome", "title": "Semaglutide alters gut microbiome diversity", "abstract": "Increased Akkermansia muciniphila. Possible mediator of metabolic effects.", "mechanism": "gut microbiome shift", "population": "obese T2DM"},
    {"pmid": "39000018", "year": 2024, "drug": "retatrutide", "organ": "metabolic_glucose", "title": "Retatrutide phase 2 obesity and glucose outcomes", "abstract": "Triple agonist with notable weight loss. Glucagon component metabolic rate increase.", "mechanism": "triple agonist glucagon energy expenditure", "population": "obese non-DM"}
  ]
}