For gallbladder or biliary disease, the composite of gallbladder or biliary disease was significantly associated with tirzepatide compared with placebo or basal insulin (RR 1.97, [95% CI] 1.14 to 3.42; I2 = 0.0%, p = 0.558), but not with the risk of cholelithiasis, cholecystitis or biliary diseases.<h4>Conclusion</h4>Based on the currently available data, tirzepatide appears to be safe regarding the risk of pancreatitis. Here, INS is linked to cholelithiasis.