In another SRM analyzing the data from nine studies with 9,871 participants, tirzepatide use was not associated with increased pancreatitis (RR: 1.46; 95% CI: 0.59–3.61).24 However, the authors noted that the gallbladder or biliary disease composite was significantly higher with tirzepatide use than with placebo or basal insulin (RR: 1.97; 95% CI: 1.14–3.42).24 As gall bladder and biliary disease tend to be more common in people with obesity, caution needs to be exercised about the use of tirzepatide in these patients. This evidence concerns the gene INS and obesity disorder.