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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Evidence synthesis · §4

Dependence of reported purity on the analytical method — summary of findings

Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.

Document identifier
CEI-ES-030/4
Series
Evidence synthesis
Version
2.2
Published
20 Nov 2025
Last reviewed
20 May 2026
Next review
20 Nov 2027
Identifier
10.71829/cei.syn.30
Certainty
High
Cycle
2025 Q4
Review type
Analytical evidence review
Search executed
06 Aug 2025

§4Summary of findings

§4.1Summary of findings

Table 7. Summary of findings for Dependence of reported purity on the analytical method.

OutcomeParticipants (studies)Effect as reportedCertaintyReason for downgrade
Anchor outcome for this review questionThe outcome the Institute designates as anchor for this indication.37,696 (24)High certainty evidence, again analytical rather than clinical, establishes that the same material can yield materially different area-percentage…Highno downgrade
Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission.27,350 (23)Reported per contributing trial; see the included-studies tableHighno downgrade
Serious adverse eventsEvent counts are low; the estimate is imprecise by construction.33,393 (23)Reported per contributing trial; see the included-studies tableModerateindirectness
Any adverse eventAscertained by spontaneous report in the contributing trials.35,382 (23)Reported per contributing trial; see the included-studies tableModeratepublication bias
Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes.

§4.2Forest plot

Contributing estimatesPoint estimates with confidence intervals for each contributing study, plotted against the line of no effect.0.250.50.7511.5Ratio measure, log scale (1 = no effect)Contributing studyEstimate (95 % CI)ACHIEVE-12025 · n=not held0.74 (0.54 to 0.93)ACHIEVE-22025 · n=not held0.83 (0.70 to 0.97)ATTAIN-12025 · n=not held0.51 (0.36 to 0.66)ATTAIN-22025 · n=not held1.10 (0.80 to 1.41)ECNO-PH3-CN-OBESITY2025 · n=6640.70 (0.52 to 0.88)ECNO-PH3-CN-T2D2025 · n=not held1.03 (0.80 to 1.26)ESSENCE2025 · n=1,1970.67 (0.50 to 0.84)EXENATIDE-GE-PD2025 · n=1940.92 (0.76 to 1.08)GLORY-12025 · n=6100.71 (0.62 to 0.81)REDEFINE-12025 · n=3,4170.37 (0.29 to 0.45)Pooled estimate0.74 (0.65 to 0.83)
Study estimatePooled estimate
Figure 1. Illustrative. Contributing estimates plotted against the line of no effect. The point estimates and intervals are the Institute's standardised representation of the contributing evidence on a common ratio scale, generated deterministically from the record identifiers; they are not the published estimates, which appear in their own units in the included-studies table and on each trial abstract. The figure is published to convey the dispersion of the evidence base, not to supply a number.

§4.3Certainty assessment for the anchor outcome

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasno downgradeInconsistencyno downgradeIndirectnessno downgradeImprecisionno downgradePublication biasno downgradeTotal downgrading: 0 levelsHigh certainty
Figure 2. Domain-by-domain certainty assessment for the anchor outcome of this review.

Table 8. Reasoning recorded against each certainty domain for the anchor outcome.

DomainRatingReasoning
Risk of biasNo concernNo serious concern identified in this domain.
InconsistencyNo concernNo serious concern identified in this domain.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionNo concernNo serious concern identified in this domain.
Publication biasNo concernNo serious concern identified in this domain.
Overall: High certainty. The Institute is confident that the true effect lies close to the estimate. Further research is very unlikely to change confidence in the estimate.

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. United States Pharmacopeial Convention. General Chapter ⟨1225⟩ Validation of Compendial Procedures. United States Pharmacopeia — National Formulary (USP–NF) 2024;USP 2024 Issue 1. identifier not held by the Institute
  2. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use. ICH Q2(R2) Validation of Analytical Procedures. ICH Harmonised Guideline 2023;Step 4 version, 1 November 2023. identifier not held by the Institute

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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