Were Filipino and Southeast Asian participants represented in major GLP-1 trials?

TL;DR

• Major global trials did count Asian participants: pooled STEP 1 and STEP 3 data reported 10.6%, while SURMOUNT-1 reported 10.9%.¹
• Dedicated East Asian trials added depth, but studies centered on Japan, South Korea, China, and Hong Kong cannot stand in for the Philippines or Southeast Asia.²
• Southeast Asian geography is visible in semaglutide research through Thailand in STEP 11 and through Malaysian and Thai sites in larger cardiovascular trials.³
• The public summaries reviewed here do not separate a Filipino subgroup, so “Asian participants were included” is not a Filipino-specific answer.⁴

For Filipino readers, the honest answer is more layered than yes or no.⁴ “Asian,” “Southeast Asian,” and “Filipino” are not interchangeable labels.⁵ A paper may report an Asian race total, while a registry lists countries where clinics operated.⁵ Neither detail automatically reveals how many participants were Filipino.⁵ Reading the records well means keeping category, geography, and identity separate.⁵

First, decide what “represented” means

Representation can describe who joined a trial, where recruitment happened, or how results were reported.⁵ These are related questions, but they are not the same.⁵ An “Asian” total may combine people with roots across a vast region.⁶ A clinic in an Asian country establishes trial geography, yet it does not reveal every participant’s citizenship or ancestry.⁵

For this article, a Filipino-specific answer requires a Filipino count or label.⁴ A Southeast Asian geographic answer requires a site in that region.⁷ An Asian answer can rely on the reported Asian category, with its limits stated.⁶ This simple three-part test keeps a broad label from doing work it cannot do.⁵

Tirzepatide is named here only as the neutral catalog reference below.⁸

The flagship trials did include Asian participants

The global STEP program offers a clear semaglutide example.¹ A later analysis pooled STEP 1 and STEP 3, where 10.6% of participants were reported as Asian.¹ In STEP 2, the reported Asian share was 27.3%.¹ Those figures establish inclusion within the broad category.¹ They do not reveal a Filipino total.¹

The large tirzepatide SURMOUNT-1 trial shows a similar pattern.⁸ FDA’s statistical review counted 276 Asian participants among 2,539 randomized participants, or 10.9%.⁸ Its country table included China, India, Japan, and Taiwan.⁸ The corresponding registry lists the same Asian locations among a wider multinational network.⁵

So the narrow answer to “Were Asians included?” is yes for these major trials.¹ The answer to “How many were Filipino?” cannot be read from those Asian totals.⁴

An Asian total is not a Filipino total

FDA guidance recommends standardized race and ethnicity reporting across trials in the United States and abroad.⁶ In that framework, Asian appears as a broad race category, while ethnicity is collected separately.⁶ The listed categories do not supply a standard Filipino line.⁶

This matters when a headline jumps from “Asian participants” to “people like us.”⁵ Asia contains many populations, languages, environments, and health systems.⁵ Aggregation can confirm that a broad group entered a trial, but it can hide which communities made up that group.⁶

STEP 1 adds a useful geography check.⁹ Its registry lists India, Japan, and Taiwan among 17 countries and territories.⁹ The Philippines is not among that specific record’s locations.⁹ That statement is limited to STEP 1.⁹ It does not prove that a Filipino person could not have participated elsewhere or that another study lacked Philippine involvement.⁵

East Asian studies added depth, not a regional substitute

Some later trials were built around East Asian populations rather than a small subgroup inside a global total.² STEP 6 randomized 401 adults through 28 clinics in Japan and South Korea.² STEP 7 randomized 375 people through centers in China, Hong Kong, Brazil, and South Korea.¹⁰ Its authors described the group as predominantly East Asian.¹⁰

Tirzepatide research also produced an East Asian pooled analysis across six SURPASS studies.¹¹ However, 94% of the analyzed participants were from Japan.¹¹ That concentration is important context for Filipino readers.¹¹

These studies make Asian evidence less dependent on a single global average.² Still, East Asia is not Southeast Asia.² Results organized around Japanese, Korean, Chinese, or Hong Kong participants should retain those labels.¹⁰ They should not be repackaged as evidence about Filipinos without Filipino-specific reporting.⁴

Southeast Asia appears more clearly in semaglutide records

STEP 11 gives the most direct example in this set.⁷ The trial enrolled 150 adults of Asian descent at 12 sites in South Korea and Thailand.⁷ Thailand provides a clear Southeast Asian location, although the publication does not provide counts for every Southeast Asian nationality.⁷

Larger semaglutide cardiovascular trials also reached the region.³ SELECT enrolled 17,604 participants worldwide, and its registry lists multiple sites in Malaysia and Thailand.³ SOUL enrolled 9,651 participants in its registry and also lists multiple Malaysian and Thai sites.¹²

This is meaningful geographic inclusion, not a Filipino subgroup result.⁵ A site list tells readers where research centers operated.³ It does not tell them the citizenship, ancestry, or home community of every enrollee.⁵ Southeast Asian presence should therefore be reported by the countries actually named: Thailand and Malaysia.⁴

Semaglutide is named here only as the neutral catalog reference below.¹

“Asia-Pacific” can still cover a narrow map

Trial names can sound more inclusive than their location tables.¹³ SURPASS-AP-Combo is a useful example because “AP” refers to Asia-Pacific.¹³ Its completed registry reports 917 participants across Australia, China, India, and South Korea.¹³ No Southeast Asian country appears in that specific location list.¹³

The lesson is not that the title is wrong.¹³ It is that a regional label may describe a selected network rather than every part of the region.¹³ Readers should open the location table and name the countries instead of assuming coverage.⁵

This check also prevents two opposite errors.⁵ One is treating any Asian site as Filipino representation.⁵ The other is overlooking real Southeast Asian participation when Thailand or Malaysia is plainly listed.³ Precision works both ways: it neither inflates inclusion nor erases it.⁴

What the public record can honestly answer

For the named trials, the broadest answer is straightforward.⁴ Asian participants were included in flagship semaglutide and tirzepatide programs.¹ Dedicated studies expanded participation in East Asian settings.² Thailand and Malaysia supplied Southeast Asian trial geography in several semaglutide records.³

The Filipino-specific answer is narrower.⁴ The public articles and summary records used here do not isolate Filipino participants as their own reported group.⁴ That is a reporting limit, not proof of universal absence.⁴ A Filipino participant could be hidden inside “Asian,” “other,” a country total, or data not shown in a public summary.⁵

For readers in the Philippines, the most useful question is therefore specific.⁵ Ask whether a claim comes from an Asian aggregate, an East Asian study, a Southeast Asian site, or an identified Filipino subgroup.⁵ Only the last category directly answers Filipino representation.⁴

Bottom line

Major GLP-1 trial programs were not entirely without Asian participation.¹ STEP and SURMOUNT records both report Asian participants, while later studies created larger East Asian groups.⁸ Southeast Asia also appears in important semaglutide research through Thai and Malaysian sites.³ Yet those facts do not settle Filipino representation.⁴ The public summaries reviewed here group people broadly or report clinic locations; they do not publish a separate Filipino count.⁴ For a Philippines-centered reading, the fair conclusion is measured: Asian inclusion is documented, Southeast Asian geography is documented in named trials, and Filipino-specific representation remains unquantified in these public reports.⁴

This article is educational research context, not medical advice. Catalog links are neutral references and do not imply a treatment or human-use recommendation.

Frequently asked questions

Were Asian participants included in the biggest semaglutide and tirzepatide trials?

Yes, in the named flagship trials.¹ Pooled STEP 1 and STEP 3 data reported 10.6% Asian participants.¹ FDA’s SURMOUNT-1 review reported 276 Asian participants, or 10.9% of 2,539 randomized people.⁸ Those totals confirm broad Asian inclusion, not Filipino-specific inclusion.⁴

Does an Asian percentage tell us how many participants were Filipino?

No.⁶ FDA’s standardized framework uses Asian as a broad race category and handles ethnicity separately.⁶ The STEP and SURMOUNT public summaries cited here do not publish a Filipino subgroup.⁴ A Filipino count therefore cannot be calculated from the Asian percentage alone.⁵

Which named trials had Southeast Asian locations?

STEP 11 operated in South Korea and Thailand.⁷ The much larger SELECT and SOUL registry records list sites in both Malaysia and Thailand.³ These entries document Southeast Asian geography.¹² They do not provide a combined Southeast Asian ethnicity total or a Filipino participant count.⁵

Were the East Asian studies representative of all Asian readers?

They should not be described that broadly.² STEP 6 centered on Japan and South Korea, while STEP 7 centered mainly on China, Hong Kong, and South Korea.¹⁰ A tirzepatide East Asian analysis was 94% Japanese.¹¹ Those populations cannot automatically represent Southeast Asia.¹¹

Why can’t a trial site prove participants’ nationality?

A registry location identifies where a research center operated.⁵ Race, ethnicity, citizenship, ancestry, and residence are different fields.⁶ People may cross borders or identify in ways a site label cannot capture.⁵ Site geography is valuable, but it cannot replace participant-level demographic reporting.⁵

What would provide a clearer Filipino answer?

A public table that separately counts Filipino participants would be the clearest answer.⁴ Country-specific enrollment could add geographic context, while subgroup reporting could show who was analyzed.⁵ Until such detail appears in a named record, “Asian included” should remain a broad statement rather than a Filipino one.⁴

Sources

Footnotes

1. Efficacy and safety of semaglutide 2.4 mg by race and ethnicity: A post hoc analysis of three randomized controlled trials. Post hoc race and ethnicity analysis of three randomized phase 3 semaglutide trials. The publication reports an aggregated Asian category and does not provide a Filipino subgroup count. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹²

2. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6). Randomized phase 3a semaglutide trial in adults from East Asia. Japan and South Korea are East Asian settings and do not establish Southeast Asian or Filipino representation. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

3. Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity. Large completed multinational semaglutide cardiovascular outcomes trial. Registry sites demonstrate geographic inclusion but do not identify every participant's nationality or ethnicity. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

4. Efficacy and safety of semaglutide 2.4 mg by race and ethnicity: A post hoc analysis of three randomized controlled trials; Statistical Review: Tirzepatide, NDA 217806; Semaglutide in an Asian population with obesity in South Korea and Thailand (STEP 11); Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity; A Heart Disease Study of Semaglutide in Patients With Type 2 Diabetes. Bounded synthesis of specified STEP, SURMOUNT, SELECT, and SOUL public records. This conclusion applies only to the named public summaries and must not be restated as proof that Filipino participants were absent from every GLP-1 trial. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹

5. Collection of Race and Ethnicity Data in Clinical Trials; STEP 1: Research Study Investigating How Well Semaglutide Works in People Suffering From Overweight or Obesity; Statistical Review: Tirzepatide, NDA 217806. Methodological reading of standardized demographic categories alongside country-level registry locations. Public summary records may not expose every demographic field collected in a trial. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶

6. Collection of Race and Ethnicity Data in Clinical Trials. U.S. FDA guidance for standardized demographic data collection and reporting in medical-product trials. A broad Asian category does not identify nationality or a specific Asian ethnic community such as Filipino participants. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

7. Semaglutide in an Asian population with obesity in South Korea and Thailand (STEP 11). Randomized phase 3 semaglutide obesity trial conducted in South Korea and Thailand. The publication does not turn Thai site participation into a count for all Southeast Asian nationalities. ↩ ↩² ↩³ ↩⁴ ↩⁵

8. Statistical Review: Tirzepatide, NDA 217806; A Study of Tirzepatide in Participants With Obesity or Overweight. FDA statistical review and completed phase 3 tirzepatide obesity trial registry record. The reported Asian total is not broken down into Filipino or Southeast Asian ethnic groups. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

9. STEP 1: Research Study Investigating How Well Semaglutide Works in People Suffering From Overweight or Obesity. Completed phase 3 semaglutide obesity trial registry record. A location list describes trial geography, not each participant's nationality, ethnicity, residence, or ancestry. ↩ ↩² ↩³ ↩⁴

10. Semaglutide for weight management in a predominantly east Asian population with overweight or obesity (STEP 7). Randomized phase 3a semaglutide trial designed for a predominantly East Asian population. The study's regional focus does not provide a Filipino subgroup count. ↩ ↩² ↩³ ↩⁴

11. Safety and efficacy analyses across age and body mass index subgroups in East Asian participants with type 2 diabetes in the phase 3 tirzepatide studies. Post hoc analysis of East Asian participants in phase 3 tirzepatide trials. This analysis mostly reflects Japanese participants and should not be generalized to Southeast Asia or the Philippines. ↩ ↩² ↩³ ↩⁴ ↩⁵

12. A Heart Disease Study of Semaglutide in Patients With Type 2 Diabetes. Large completed multinational semaglutide cardiovascular outcomes trial. The public location list cannot by itself provide Filipino or country-specific participant counts. ↩ ↩²

13. A Study of Tirzepatide in Participants With Type 2 Diabetes on Metformin With or Without Sulfonylurea (SURPASS-AP-Combo). Completed phase 3 tirzepatide trial with 917 participants. The claim is limited to the locations in this registry record and does not imply that other tirzepatide studies lack Southeast Asian sites. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶