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The JAMA Internal Medicine meta-analysis of 76 randomized trials quantified the class-wide risk: Cholelithiasis: relative risk 1.27 across all GLP-1 RAs Cholecystitis: relative risk 1.36 Biliary disease composite: relative risk 1.55 Higher doses carried higher risk than lower doses Longer treatment duration carried higher risk than shorter duration For high-risk populations, particularly older women, close monitoring for cholecystitis and cholelithiasis during GLP-1 therapy is recommended

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Data sharing statement Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval